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CIMI Expeditions Baja - Camper Reference Survey

Someone you know has applied to attend a 2-week international trip in Baja, Mexico. Your critical appraisal and confidential evaluation of this applicant will greatly help in our decision making process for acceptance. We appreciate you providing a candid, objective, and honest assessment of the candidate.

On many occasions, we find it necessary to approve campers based on information supplied by references and statements made by the potential camper. Therefore, we hope you will be frank, candid, and objective so that we may avoid decisions that could result in a negative group dynamics and perhaps removal from the program.

Thank you for your response and kind assistance.

1. Name of Applicant? *This question is required.

2. How long have you known the applicant? *This question is required.

3. In what capacity do you know the applicant? *This question is required.

4. Please rate the applicant on the following (1 star = lowest rating, and 5 stars = highest rating):

Space Cell	Rating
Maturity compared to peers	Reset star selection 1 out of 5 stars for Maturity compared to peers: Rating 2 out of 5 stars for Maturity compared to peers: Rating 3 out of 5 stars for Maturity compared to peers: Rating 4 out of 5 stars for Maturity compared to peers: Rating 5 out of 5 stars for Maturity compared to peers: Rating
Team Player	Reset star selection 1 out of 5 stars for Team Player: Rating 2 out of 5 stars for Team Player: Rating 3 out of 5 stars for Team Player: Rating 4 out of 5 stars for Team Player: Rating 5 out of 5 stars for Team Player: Rating
Enthusiasm & Energy	Reset star selection 1 out of 5 stars for Enthusiasm & Energy: Rating 2 out of 5 stars for Enthusiasm & Energy: Rating 3 out of 5 stars for Enthusiasm & Energy: Rating 4 out of 5 stars for Enthusiasm & Energy: Rating 5 out of 5 stars for Enthusiasm & Energy: Rating
Ability to take direction & guidance	Reset star selection 1 out of 5 stars for Ability to take direction & guidance : Rating 2 out of 5 stars for Ability to take direction & guidance : Rating 3 out of 5 stars for Ability to take direction & guidance : Rating 4 out of 5 stars for Ability to take direction & guidance : Rating 5 out of 5 stars for Ability to take direction & guidance : Rating
Ability to take initiative	Reset star selection 1 out of 5 stars for Ability to take initiative: Rating 2 out of 5 stars for Ability to take initiative: Rating 3 out of 5 stars for Ability to take initiative: Rating 4 out of 5 stars for Ability to take initiative: Rating 5 out of 5 stars for Ability to take initiative: Rating
Judgment	Reset star selection 1 out of 5 stars for Judgment : Rating 2 out of 5 stars for Judgment : Rating 3 out of 5 stars for Judgment : Rating 4 out of 5 stars for Judgment : Rating 5 out of 5 stars for Judgment : Rating
Adaptability	Reset star selection 1 out of 5 stars for Adaptability: Rating 2 out of 5 stars for Adaptability: Rating 3 out of 5 stars for Adaptability: Rating 4 out of 5 stars for Adaptability: Rating 5 out of 5 stars for Adaptability: Rating
Honesty	Reset star selection 1 out of 5 stars for Honesty: Rating 2 out of 5 stars for Honesty: Rating 3 out of 5 stars for Honesty: Rating 4 out of 5 stars for Honesty: Rating 5 out of 5 stars for Honesty: Rating
Ability to effectively communicate needs	Reset star selection 1 out of 5 stars for Ability to effectively communicate needs: Rating 2 out of 5 stars for Ability to effectively communicate needs: Rating 3 out of 5 stars for Ability to effectively communicate needs: Rating 4 out of 5 stars for Ability to effectively communicate needs: Rating 5 out of 5 stars for Ability to effectively communicate needs: Rating
Cheerfulness in the face of adversity	Reset star selection 1 out of 5 stars for Cheerfulness in the face of adversity: Rating 2 out of 5 stars for Cheerfulness in the face of adversity: Rating 3 out of 5 stars for Cheerfulness in the face of adversity: Rating 4 out of 5 stars for Cheerfulness in the face of adversity: Rating 5 out of 5 stars for Cheerfulness in the face of adversity: Rating
Grit	Reset star selection 1 out of 5 stars for Grit: Rating 2 out of 5 stars for Grit: Rating 3 out of 5 stars for Grit: Rating 4 out of 5 stars for Grit: Rating 5 out of 5 stars for Grit: Rating
Ability to handle new experiences	Reset star selection 1 out of 5 stars for Ability to handle new experiences: Rating 2 out of 5 stars for Ability to handle new experiences: Rating 3 out of 5 stars for Ability to handle new experiences: Rating 4 out of 5 stars for Ability to handle new experiences: Rating 5 out of 5 stars for Ability to handle new experiences: Rating
Ability to be Inclusive of differing ideas	Reset star selection 1 out of 5 stars for Ability to be Inclusive of differing ideas: Rating 2 out of 5 stars for Ability to be Inclusive of differing ideas: Rating 3 out of 5 stars for Ability to be Inclusive of differing ideas: Rating 4 out of 5 stars for Ability to be Inclusive of differing ideas: Rating 5 out of 5 stars for Ability to be Inclusive of differing ideas: Rating

5. If you rated the applicant two-stars or lower for any of the above, please elaborate here:

6. Would you feel comfortable having the applicant be in a living situation with your child(ren) or other children? *This question is required.

7. Can you share anything about how this applicant would (or has) react(ed) in a stressful situation?

8. Would you recommend this applicant for international group-based travel?

Please enter an 'other' value for this selection.

9. To your knowledge, has this student had any significant behavioral challenges that are relevant to their participation in this program?

Please enter an 'other' value for this selection.

10. Is there anything else you would like to share about the student as we assess their candidacy for acceptance?