Camper Reference Form

Camper Reference Form to be completed by someone who has supervised the camper within the last year.

Camper's Name

First

Last

How long have you known the applicant?

What is your relationship to the applicant?

i.e. coach, teacher, etc.

Describe the behavior you most often observe in this camper.

Do you have any concerns about this camper participating in a week of camp at Camp Pinnacle?

Yes

If yes, please explain.

Please share any other information that may be pertinent related to this camper receiving a scholarship to attend Camp Pinnacle.

Reference Name

First

Last

Reference Email

Reference Home Phone

Reference Cell Phone

Reference Signature

Date

If you are human, leave this field blank.