Joshua Center for Neurological Disorders Camp Staff Reference Form Please complete this form as requested by your friend/colleague. What is your name?* First Last What is the name of the individual you are providing reference information for?* First Last How long have you known the individual?*This individual ...has the qualifications to meet the challenges of children with disabilities.doesn't have the qualifications to meet the challenges of children with disabilities.How do you know the individual requesting you as a reference?*is a current employeeis a former employeeserved as a volunteeris a student1. Rate the work history of this individual.*PoorFairGoodVery GoodExcellent2. Rate how well you feel this individual is qualified to perform the camp assignment.*PoorFairGoodVery GoodExcellent3. Rate this individual’s ability to interact with children.*PoorFairGoodVery GoodExcellentEmailThis field is for validation purposes and should be left unchanged.