Staff Application

POSITION(S) APPLYING FOR:

Cabin Counselor Arts and Crafts Instructor Sports/Games Inst
Assist. Counselor Nature Instructor Adventure Instructor
Camp Nurse Archery Instructor Jr. Counselor Coord.
Camp Physician Music/Drama Instructor Other
   
 
T. Shirt Size
Name Birth date Sex
Address
City State  Zip
Phones: Day Evening Email
Employer  Phone
 
 Students
School City State
Major
 
PREVIOUS CAMP EXPERIENCE (List most recent first)

Camp and position held
Date

Camp and position held
Date

Camp and position held
Date
 
EMPLOYMENT HISTORY (List most recent first)

Employer/Position
Date

Employer/Position
Date

Employer/Position
Date
 
EXPERIENCE WITH CHRONICALLY ILL CHILDREN

Explain
Date

Explain
Date

CAMP SKILLS AND ABILITIES

Current CPR Card  Date Water Safety Instructor  Date
Current First Aide Card Standard  Date Advanced  Date
Musical Instruments Played
Fluent in language other than English
 
Check level of ability for the following:
  Experience Interest Ability To Teach Explain
Field Sports
Arts & Crafts
Music & Singing
Drama
Folk Dancing
Swimming
Boating/Sailing
Nature

Other information/comments regarding camping skills, abilities, or experience

What special contributions do you think you can make at camp?

List three people who know you well. Please include a former employer.

1.

Name
Position/Relationship
Phone

Address Street
City
State
Zip
2.

Name
Position/Relationship
Phone

Address Street
City
State
Zip
3.

Name
Position/Relationship
Phone

Address Street
City
State
Zip

Have you ever been convicted of a felony or misdemeanor?

Have you ever been convicted of child abuse or sexual abuse?

I certify that the answers to the above questions and statements are true and correct. I authorize the governing body of Camp Sunshine Dreams to contact present and past employers, schools, and references. I understand that all facts stated in the application are open to investigation.

 

_____________________________________________________
Signature
Date