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Thank you for completing this GOALS reference form.

A child you know has asked you to help us understand just who they are.

The questions below are designed to help us identify which expedition is most appropriate for this particular applicant. GOALS programs are designed to make a profoundly positive impact on kids who are:

- ready for a true wilderness expedition,
- aware that the experience is designed to be much more than “just a river trip”
- eager to dive in to the unique activities and lessons we have developed to create connections to peers, planet, and self.

The applicant who listed you as a reference has answered a very similar set of questions - and the combination of their responses and yours will help us to gain a solid understanding of them.

If you have any further questions, please contact GOALS Youth River Expeditions.


- SECTION 1. REFERENCE - BASIC INFORMATION -
Name of the CHILD who listed you as a reference: *
Name of the CHILD who listed you as a reference:
Name of the MENTOR completing this reference form: *
Name of the MENTOR completing this reference form:
- SECTION 2. PERSONALITY ASSESSMENT -
Please rank the statements below from "I strongly disagree" to "I strongly agree." *
Please rank the statements below from "I strongly disagree" to "I strongly agree."
1. This child FOLLOWS INSTRUCTIONS. When an adult in a position of authority (teacher, coach, etc.) asks them to do something, they complete it as asked.
2. This child is NATURALLY CURIOUS. They seek ways to gather new information about the things they find interesting.
3. This child is COMFORTABLE IN THE WILDERNESS. Being in wild places without cars, phones, or other conveniences does not scare them.
4. This child is a LEADER. People look up to them as someone who takes action.
5. This child is TRUSTWORTHY. Even when no one is watching, they make good choices.
6. This child is INDEPENDENT. They can spend time away from their home and their family without becoming homesick.
7. This child is PHYSICALLY STRONG. They can use their body to accomplish tasks that require strength.
8. This child is SELF-CONFIDENT. They believe they can overcome any reasonable challenge that comes their way.
Please use the box below to provide explanation(s) for any answers above you feel need some clarification. This is not required - and only necessary if you feel it is so.
- SECTION 3. MULTIPLE CHOICE QUESTIONS. -
For this section, please choose ONLY ONE answer that you feel best represents how the child you are referring would respond in each scenario.
QUESTION 1. The child you are acting as a reference for has just completed their first year on a youth soccer team. Their team is celebrating the end of their season with a sleepover party, but sleepovers have always been a challenge for this child. Even so, they decide to give this one a try because their best friend is also on the team. While driving to the party, their parents learn that the friend they were looking forward to being there has caught the flu and can’t make it. The applicant you are referring is mostly to: *
Please select ONLY ONE answer from the options below.
QUESTION 2. Tonight is the school carnival – a fun event that many people who live in your community look forward to. A teacher has volunteered this child's homeroom class to clean up the school’s front parking lot area during recess to help get ready for the event. The applicant you are referring is most likely to: *
Please select ONLY ONE answer from the options below.
QUESTION 3. This child has spent six long hours driving to a campsite in Utah, where they will spend the night before their river trip begins. As the vans get unloaded, a boy they didn't know before the trip realizes he left his duffle bag in the parking lot where the group met this morning. He has nothing more than what he is wearing. This applicant is most likely to: *
Please select ONLY ONE answer from the options below:
QUESTION 4. It is the first afternoon in the canyon. This applicant pairs up with a friend to set up their tent - something neither of them have ever done before. After finding the perfect spot, they give it a try. 30 minutes later everyone else has their tents set up properly, but theirs is slumping over and they seem to have an extra pole. This applicant is most likely to: *
Please select ONLY ONE answer from the options below.
QUESTION 5. This child just sat down in their camp chair for dinner, and noticed a giant bug with big pinchers crawling directly toward their foot. Their next move is most likely to be: *
Please select ONLY ONE answer from the options below:
QUESTION 6. While taking their tent down on the final morning of the trip, this applicant and their friend each grab a tent pole and begin a make-believe sword fight game. During the game, they accidentally break one of the poles by smacking it against a tree. This applicant would likely then: *
Please select ONLY ONE answer from the options below:
- SECTION 4. SHORT ANSWER RESPONSES -
Please answer the following questions as thoroughly as you feel you need to in order to explain your ideas and opinions.
- YOU'RE ALL DONE - THANK YOU FOR YOUR INPUT! -
Thank you for your helping GOALS Youth River Expeditions get to know the child who listed you as one of their references. After reviewing your answers, please submit them using the button below. Once submitted, your responses can not be changed - though you can always reach us through info@goalsonrivers.org.