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Dates Available From *

Dates Available To *

Unavailable Dates (if any)

At which site are you applying *

What type of position do you want *

Salary desired

Do you meet or exceed any minimum age requirements for that position

Yes

Don't Know

Can you perform the essential function of the job for which you have applied, with or without reasonable accommodations

Yes

If you are hired, would you desire or need housing for any person(s) other than yourself at the camp

Yes

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Past Work History
List most recent employer first

Employer's Name

Employer's Phone

Address

City

State

Zip

Dates of Employment

Responsibilities

Employer's Name

Employer's Phone

Address

City

State

Zip

Dates of Employment

Responsibilities

Employer's Name

Employer's Phone

Address

City

State

Zip

Dates of Employment

Responsibilities

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Write a brief biographical sketch, including 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. *

Please list any Camp Program Skills you might have.

Do you hold any current certification in courses that would apply to summer camp? (First Aid, Life Guarding, etc. Give expiration dates.)

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

What impact do you think a well-run camp can make in the lives of children? *

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Harassment Policy
The camp’s policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment.

Have you ever been accused of harassment of any person including, but not limited to, workplace harassment? (Note: a prior accusation is not an automatic bar to employment. The type of accusation and when it occurred will be evaluated by the camp before any decision is made.) *

Yes

Explain

Criminal Record

Have you ever been convicted of a crime, other than a minor traffic offense? If yes, please describe. (Note: a prior conviction is not an automatic bar to employment. The type of conviction and when it occurred will be evaluated by the camp before any decision is made.) *

Yes

Explain

I authorize investigation of all statements herein, including any checks of criminal records, and release the camp and all others from liability in connection with same. I understand that, if employed, I will be an at-will employee unless there is an agreement or 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 documents completed or submitted by the applicant will result in dismissal, regardless of the date of discovery by the camp.

Signature (Type Name) *

Today's Date *

All statements become part of any future employee personnel files.

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Permanent Address *

School Address

Past Work History
List most recent employer first

References *
Give names and addresses of three adults **[not relatives]** having knowledge of your character, experience, work habits, and ability.

Camp Experience

Education
High School and Beyond

Harassment Policy
The camp’s policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment.

Criminal Record

Kirchenwald

Nawakwa

The Wittel Farm

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Permanent Address *

School Address

Past Work HistoryList most recent employer first

References * Give names and addresses of three adults [not relatives] having knowledge of your character, experience, work habits, and ability.

Camp Experience

EducationHigh School and Beyond

Harassment PolicyThe camp’s policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment.

Criminal Record

Kirchenwald

Nawakwa

The Wittel Farm

Past Work History
List most recent employer first

References *
Give names and addresses of three adults **[not relatives]** having knowledge of your character, experience, work habits, and ability.

Education
High School and Beyond

Harassment Policy
The camp’s policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment.