Camp Staff Application

Name

Date of Application

/ /

Permanent Address

Phone Number

Fax

E-mail Address

What type of position do you want at camp?

Salary desired?

Do you meet or exceed any minimum age requirements for that position?

Don’t know minimum age

Yes

Can you perform the essential functions of the job for which you have applied, with or without reasonable accommodation?

Yes

If you are hired would you desire or need housing for any person(s) other than yourself at the camp?

Yes

Past Work History Provide a full record of all employment — paid and volunteer — and explain any gaps in employment. Include any positions on camp staff. Use a separate sheet, if necessary.

Dates. Employer/Supervisor. Address & Phone. Nature of Work. Reason for Leaving

Indicate any employer you do not wish us to contact, and the reason

References Give names and addresses of three persons [not relatives] having knowledge of your character, experience, work habits, and ability.

Name, Address & City Phone

Education High School and Beyond

Years. School. Major Subjects. Degree Granted

Camp Experience

Dates Camp & Director Location Camper or Staff?

Please rate your skills in the following areas (1=poor, 3=average, 5=exceptional)

Nature

birds

wildflowers

forest communities

mammal study

anthropods

earth Science

wetland communities

Please List

weather

Wilderness Trips - Skills

rafting

hiking

kayaking

canoeing

backpacking

climbing/rappelling

outdoor cooking

Leave No Trace

challenge/ropes course

team building

orienteering

Other

(Please list)

Music

singing

instrument

(list)

storytelling

Miscellaneous

Other

Please List

Certifications and Camp Support Staff Skills

In the following list, please check those items in which you have experience and skills. Mark with a “C” those for which you hold current certification and attach a copy of your certification.

Business/Administration

bookkeeping/accounting

computer/technical

computer/software

(list)

CPR

first aid

lifeguard

Write a brief biographical sketch, including specialized training in camping, and experience or training in other fields which might have a bearing on the position(s) for which you are applying. Attach a separate sheet if necessary.

Text Format

Answer these questions only if applying for a position requiring driving

Do you have a valid driver’s license?

Yes

State

Do you have current chauffeur’s-type license?

Yes

Do you have a commercial driver’s license?

Yes

What contributions do you think you can make at camp?

What contributions do you think a well-run camp can make to children?

Harassment

The camp’s policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment. Have you ever been accused of harassment of any person including, but not limited to, workplace harassment? (Note: a prior accusation is not an automatic bar to employment. The type of accusation and when it occurred will be evaluated by the camp before any decision is made.)

Yes

Explain

School or Business Address

Address. Phone Number. Fax Number. Email

Criminal Record

Have you ever been convicted of a crime, other than a minor traffic offense? If yes, please describe. (Note: a prior conviction is not an automatic bar to employment. The type of conviction and when it occurred will be evaluated by the camp before any decision is made.)

Yes

Explain

Indicate any employer you do not wish us to contact, and the reason

Permission

I authorize investigation of all statements herein, including any checks of criminal records, and release the camp and all others from liability in connection with same. I understand that , if employed, I will be an at-will employee unless there is an agreement or law which alters that status. Furthermore, I understand that any agreement must be in writing and signed by the designated camp official. I also understand that misrepresentations or falsifications herein or in other documents completed or submitted by the applicant will result in dismissal, regardless of the date of discovery by the camp.

Name

First and Last

Dates Available From

Other

(Please list)

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