Personal Information
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| First Name: |
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| Last Name: |
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| Summer Address: |
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| City: |
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| State/Zip: |
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| Day/Eve.Phone: |
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| Cell/Fax Phone: |
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| Email: |
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| Available to work: |
Full Time (8am - 4pm)
AM Part Time (7:30am - 12:30 pm)
PM Part Time (12:30pm - 5:00 pm)
Substitute/On-Call
August Only
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Yes, I am CPR Certified.
Certification Expires on:
(Format: yyyy/mm/dd) |
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Yes, I am First Aid Certified.
Certification Expires on:
(Format: yyyy/mm/dd) |
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| How Did You Hear About Us?: |
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Education |
| High School Name/Graduation Date: |
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| HS City/State: |
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| College Name: |
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| College City/State: |
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| AA Subject/Year: |
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| BA/BS Subject/Year: |
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| MA/MS Subject/Year: |
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Degree Expected:
(Subject/Year) |
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| Other related educational
experiences.... |
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Past Employment History |
| Company 1: |
| Name: |
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| Address: |
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| Phone Number: |
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| May we call as a reference?: |
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| Supervisor Name: |
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| Employment Date: |
Start: End: |
| Job Title: |
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| Responsibilities: |
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| Company 2: |
| Name: |
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| Address: |
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| Phone Number: |
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| May we call as a reference?: |
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| Supervisor Name: |
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| Employment Date: |
Start: End: |
| Job Title: |
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| Responsibilities: |
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Relevant Experiences |
| What do you feel makes a great camp teacher?: |
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| What experience have you had working at camps or after school programs?: |
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| How would you describe your leadership style? What leadership experiences have you had?: |
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| What do you consider three necessary components of a successful team? When have you been a part of a team and put these components into action? : |
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| What is the most rewarding experience you have had working with children? What made it so worthwhile? : |
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| It is the first morning of camp and you and your fellow teachers are preparing for the morning rally to get 30 campers excited for their week at camp! What suggestions would you have for the team and what role would you want to play?: |
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| Have you ever been convicted of a crime, other than a minor traffic offense? If yes, please provide full details in the box to the right: |
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| I authorize investigation of all statements herein, including any checks of criminal records, and release the company and all others from liability in connection with the same. I understand that if employed, I will be an at-will employee unless there is an agreement of 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 ducuments completed or submitted by the applicant will result in dismissal, regardless of the date of discovery by the camp. |
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Other Information |
Yes - I am able to attend both days of the Training Workshop:
(select only 1 workshop location) |
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| YES! I am available to work during the following weeks: |
All Sites
6/13 - 6/17 6/20 - 6/24 6/27 - 7/01
7/05 - 7/08* 7/11 - 7/15 7/18 - 7/22
7/25 - 7/29
8/01 - 8/05
8/08 - 8/12
8/15 - 8/19 8/22 - 8/26 8/29 - 9/02
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Preferred Destinations:
(Please refer to the Destinations Listings and
indicate your 1st, 2nd and 3rd preferred destinations.) |
| 1st Preference: |
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| 2nd Preference: |
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| 3rd Preference: |
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