Your Name: Gender: Male Female   Age: under 19over 19 over 21
	Street: City: State: AKALARAZCACOCTD.C.DEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWYOther ZIP: Country: Phone:
	Street: City: State: AKALARAZCACOCTD.C.DEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWYOther ZIP: Country: Phone:
	eMail-Address:

 

• PE(Personal experience) rating scale: 10 = Excellent; 9 = Very good; 8 = Good; 7 = Fair
• TA(Teaching ability): 10 = Able to lead program; 9 = Able to lead after refresher; 8 = Able to assist

• WE(Work experience) rating scale: 10 = Excellent; 9 = Very good; 8 = Good; 7 = Fair
• PI(Personal interest) rating scale: 10 = Excellent; 9 = Very good; 8 = Good; 7 = Fair

In the boxes below, list your top 3 skills that you are capable of doing at camp.  Please select these top skills from the skills you listed previously.  Detail your experience in these 3 top areas--positions held, work performed, duties, responsibilities, and length of time in each skill area. Include any certification or training here as well.
 

Skill 1:
Skill 2:
Skill 3:

Please give the following details for each job:
contact for reference, dates, employer (name, address, telephone), supervisor name, nature of work, reason for leaving

Camp Experience
Please give the following details for each camp:
dates, camp director, address, telephone, staff or camper

 
Education
Please give the following details for each school/college:
years, name of school/college, major, date completed

 
References
List the three people you have given your reference sheets to here. These people should have knowledge of your character, experience & ability. Do not use relatives and do not use your work supervisor.

Please give the following details:
name, address, city, state, telephone, What capacity and how long?

Reference 1:
Reference 2:
Reference 3:

Which of the following current certifications do you have:

First Aid (good 3 years)	CPR (good 1 year)	CPR Pro (good 1 year)
Lifeguard Training (good 3 years)	Water Safety Instructor	Boating Licence?

 

Other Certifications?

Patience 10987 Sense of humor 10987 Ability to follow orders 10987 Maturity 10987

Write a brief biographical sketch, including volunteering, 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.

What would you most want children to learn from you at camp?

How would you describe yourself to someone who didn’t know you?

Why should a camp director choose you as a staff member?

Experience with people (All applicants complete)

Are you willing to work with people of all racial, ethnic, and religious backgrounds? 

Please check the age group(s) with which you have had prior working or volunteering experience.
4-6 years 7-9 year 10-12 years 13-16 years Young Adults Adults

Describe in detail all experience you have had with the groups listed above.  List ages, responsibilities, work and length.