* Full Name

I Like To Be Called

* Email Address

Social Security Number

* Home Address

* Home Phone

* City	* State	* Zip

* School Address

* School Phone

* City	* State	* Zip

Birthdate: Month Day Year 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 90 89 88 87 86 85 84 83 82 81 80 79 78 77 76 75 74 73 72 71 70 69 68 67 66 65 64 63 62 61 60 59 58 57 56 55 54 53 52 51 50 49 48 47 46 43 42 41 40 39 38 37 36 35 34 33 32 31 30 29 28 27 26 25 24 23 22 21 20 19

Sex: Male Female

Height

Weight

Marital Status	Drivers Lic.#:	State

Homepage

Best Time To Call

Present Occupation

Availability & Work Preferences

* I will be available to work the following dates: From June SELECT DAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 through August SELECT DAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

* I'd like to work at: You may select more than one. Woodland (Girls Camp) Towering Pines (Boys Camp)

* Position Desired You may select more than one Counselor Nurse Maintenance Cook Food Services Assistant Director

* Education

School - Major/Minor - Years - Degree




Experience

List and give dates of work, camp, travel, military or other life experiences.
Dates - Employer - Position/Description - City/State




Campus Life

Tell us about yourself - include interests, clubs, organizations etc.




References

Please list at least 3 former employers, teachers, coaches, group leaders, etc.
Name - Position - Telephone - Address




Group Living:

What is your age group preference:

PLEASE SELECT 7-9 10-12 13-14 15-16

Activities

Rate yourself as realistically as possible by:

• Checking a 1 by those activities you can organize, teach and coach.
• Checking a 2 by those activities you have a strong background & can actively assist.

If so, for what?

Describe current medication, drugs, etc.

Do you smoke?
Yes
No

If so, will you refrain from smoking at camp?
Yes
No

Do you have any physical limitations?
Yes
No

Explain:




General Questions

How did you learn about this position?

What do you see as the most important consideration in working with children?

What are your personal expectations for the camp summer?




What's In It For You?

A summer camp job offers opportunities for teaching experience, studying group relationships, practicing leadership skills & team building, not to mention having a great summer working in the out of doors! In submitting this application you indicate that you have a strong desire to be a positive role model and influence upon children. We look forward to getting to know you better through the interview process - thank you for your interest in our camps!

* I affirm that the above information is correct and authorize the camp to pursue any background information necessary to verify my suitability for employment.