Staff Application Form
Name
First
Last
Date of Birth
MM
/
DD
/
YYYY
Permanent Address
Address
City
State
Zip
School Address
Address
City
State
Zip
Home Phone
###
-
###
-
####
Cell Phone
###
-
###
-
####
Email
Number of seasons in camp as a counselor or equivalent experience?
Year
Camp Name
Position Held
Have you ever been convicted of a sexual offense?
No
Yes
What is your intended vocation?
What activities would you prefer to direct (List three in order of choice)?
What age camper would you prefer to have in your cabin – 8 through 15 years (List three in order of choice)?
Salary at last camp
Minimum salary expected
Present year or class in college
Name of College
CHECK X FOR ACTIVITIES YOU CAN ASSIST, XX THOSE CAPABLE OF COACHING, XXX THOSE WHICH
YOU ARE AN EXPERT AND HAVE COACHED AND ARE TRAINED
ARTS & CRAFTS
ATHLETICS
CAMP CRAFTS
Batiking
Aerobics
Mountain Climbing
Ceramics
Archery
Nature
Clay
Basketball
Overnight Camping
Copper Enamel
Challenge Course
DANCE
Drawing
Field Hockey
Jazz
Jewelry
Golf
Modern
Painting
Gymnastics
Square & Folk
Sewing
Jogging
Tap
Tye-dying
Lacrosse
DRAMATICS
Weaving
Riding (English)
Directing
Woodworking
Rock Wall
Staging
MUSIC
Soccer
OTHER
Choral
Softball
Campfires
Musical Instrument
Tennis
Certification
Song Leading
Track
CPR
Volleyball
First Aid
EMT
Newspaper
Office Support
Story Telling
WATERSPORTS
Canoeing
Crew
Drive Ski Boat
Life Saving
Row Boating
Sailing
Swimming
Water Pagentry
Waterskiing
Water Safefty Instruction
exp. 00/00
Windsurfing
Tell us a little about yourself
Do Not Fill This Out