CSSM MINISTRIES SASKATCHEWAN BRANCH

______is an applicant for work with CSSM Ministries at ______CAMP. Your name has been given as reference. We shall appreciate straight forward answers to the following questions and your frank opinion of the applicant. We are relying on you to state, to the best of your knowledge, whether you believe the applicant is qualified to serve the Lord under the auspices of our Mission. Your early response will enable us to let the applicant know our committees' decision at an early date. Your reply will be kept strictly confidential. It is in the interest of both the applicant and the Mission that an honest appraisal be given.

1.How long have you known the applicant?______2.Relationship to applicant?______3.Does this person display sound Christian morals?______Have you ever had occasion to question the applicant's morals? ___ no ___yes (if yes please explain): ______4. Do they have a consistent Christian testimony and influence? a) in the church? ______b) in their community? ______5. Would they be loyal and keep a confidence?______6. How does the applicant respond to authority?______7. Have you observed any physical weaknesses or emotional problem that would hinder the applicants’ involvement in an intensive camping program? ___ no ___yes (if yes please explain): ______8. Please list any skills, talents, personality, and character strengths you have observed: ______9. Please list any personality or character weaknesses you have observed: ______10. Describe applicant's work ethic: ______11. Do you recommend that we accept this applicant? ____yes ____with reservation ____unsure ____ no. If other than yes, please give a brief statement regarding your recommendation: ______If you have further information which you feel could be helpful, please us a separate page or call the CSSM office at (306)756-2300.

Name and address of person filling out form: First:______Last:______

Address:______City/Town:______Prov/State:______

Postal code/zip______Phone #:______

______Signature of person filling out form date

PLEASE MAIL OR FAX DIRECTLY TO THE CAMP THE APPLICANT IS APPLYING TO WORK AT.

Cypress Hills Camp Madge Lake Bible Camp PO Box 786 Maple Creek SK S0N 1N0 PO Box 183 Swan River MB R0L 1Z0 Ph: (306) 662-3956 Fax: 662 4281 Ph: (306) 542-3134 [email protected] [email protected]

Dallas Valley Ranch Camp Manitou Lake Bible Camp Box 779 Lumsden SK S0G 3C0 PO Box 226 Marsden SK S0M 1P0 Ph: (306)731-3348 Fax: (306) 731-3375 Ph: (306) 826-5440 Fax: (306) 826-5405 [email protected] [email protected]

Estevan Bible Camp Ranger Lake Bible Camp Box 771 Estevan SK S4A-2A6 315 Lenore Dr Saskatoon SK S7K 7Z5 [email protected] Ph: (306) 249-6449 Fax: (888) 349-6188 [email protected] Glad Tidings Bible Camp Box 400 Mazenod Stoney Lake Bible Camp Sask S0H 3Y0 PO Box 3717 Melfort SK S0E 1A0 Ph: (306) 354-7773 Ph: (306) 783-5537 Fax: (306) 873-2277 [email protected] Kenosee Lake Bible Camp Box 217 Kenosee Lake SK S0C 2C0 Torch Trail Bible Camp Ph: (306) 577-4623 Fax: (306) 577-4622 PO Box 84 Choiceland SK S0J 0M0 [email protected] Ph: (306) 428-2989 Fax: (306) 428-2444 [email protected] Luseland Bible Camp PO Box 71 Luseland SK S0L 2A0 Ph: (306) 372-4544 [email protected]