The Camp Koby Mandell Summer in Israel Experience

                                               Recommendation Form 2011

The person who has requested this recommendation from you has applied for The Camp Koby Summer in Israel Experience. 
This Summer program has a very strong leadership element, working with Israeli children who were affected by the loss of a loved one.
Since there is only a limited amount of information which can be received in an interview, it is crucial for
us to obtain as much information as possible about the applicant’s personality, motivation, creativity, social adjustment, and independence.

We appreciate your candor in addressing these issues, and we thank
you for helping us assess the applicant’s candidacy to our program.

We would prefer that this form is filled out online.
If you prefer you can
and send it by fax to (206) 350-7467 or mail to:
Rabbi Dovid Kupinsky
The Koby Mandell Foundation
366 Pearsall Avenue
Cedarhurst, NY 11516
Tel:   (301) 576-6235
Fax:  (206) 350-7467


 Please fill out all fields
Information about Person Completing this Form 
 First Name                                                          Last Name                                                       Title                                  Length of acquaintance with the applicant
Phone                                                  Occupation                                                            Email                                                                       Relationship to Camper
Applicant's Information
Applicant's First Name                                    Applicant's Last Name
 Level of spoken Hebrew                               Level of religious observance


Very much so

More than average


Very little

Not at all





conforms to rules and regulations 

ability to adapt

has leadership qualities

ability to interact with peers

tends to be a leader

appropriate to be a counselor in a co-ed environment

Additional Information
Please add any additional information you feel is relevant
Overall Recommendation 

Very Strongly Strongly Somewhat With Reservations  Not at All

I recommend this applicant for the Camp Koby Experience

When you are finished please click the SUBMIT button
If you have trouble submitting please fax to (206) 350-7467