| Personal Information: |
Name: |
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Date
of Birth: |
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Social
Security #: |
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Gender: |
male:
| female:
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Current
Address: Street: |
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City: |
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State: |
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Zip: |
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Phone: |
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E-mail: |
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| Dates that you are available: |
| From:
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| Until:
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| Educational
Background: |
Last
Grade Completed: |
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School: |
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College/Univ.
Attending
(or Graduated from): |
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Major(s): |
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Expected/Graduation
Date: |
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Permanent Address (if different): |
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City: |
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State: |
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Zip: |
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| Emergency
Contact: |
Name: |
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Phone: |
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Have you ever been convicted of a crime/felony or misdemeanor, including
moving traffic violations? If yes, please explain. |
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Do
you smoke? |
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Do
you consume alcoholic beverages? |
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Please
List Camp Experience, as an employee and/or a camper. |
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Please
List Former Employment situations, most recent first: Please list
clubs, sports teams, social activities, military experience, technical
experience or other areas of personal interest. |
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Please
list any health problems which may interfere with fulfilling job
responsibilities.
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| Check
positions you are interested in applying for: |
Group
Counselor |
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Maintenance/Facility |
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Activity
Specialist |
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Kitchen |
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Aquatics
Staff |
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Office/Administration |
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| Camp
staff are diverse people. Please check areas you feel you could
be an asset at camp (areas you like and where you feel you could
help teach the campers). It's all about FUN and safety! |
Archery |
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Plants |
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Dance |
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Ropes |
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Volleyball |
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Tennis |
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English
Horseback Riding |
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Floor
Hockey |
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Arts
& Crafts |
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Kickball |
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Drama |
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Canoeing |
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Soccer |
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Golf |
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Western
Horseback Riding |
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Roller
Hockey |
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Ecology |
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Landscape |
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Cooking |
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Diving |
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Softball |
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Hiking |
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Nature
Specialty |
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Outdoor
Living Skills |
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Music |
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Swimming |
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Field
Games |
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Maintenance |
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Basketball |
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Computer/Office |
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Small
Animal Care |
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Other |
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| Please
answer the following questions. |
Please list any aquatic teaching experience/lifesaving certificates
held and dates of expiration:
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What
3 things about you would make you a good counselor/camp staff? Give
Details:
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| What one "flaw" in your personality do you wish to change
most and why?
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What
role do you think competition should play at camp?
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What
do you think a child should gain from a summer at camp?
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Please
give 3 personal references, non-family individuals who can attest
to your interaction while working with children. Ex: families baby
sit/sat for, tutoring, religious affiliations, friends of the family,
etc.
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| Security Image: |
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