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Fields marked with an asterisk (*) must be filled out before submitting.
Personal Details
First Name *
Last Name *
Email Address *
Contact Details
Address
City
State
Zip Code
Home Phone
Cell Phone
Qualifications
Age 15 to 17 *
Yes
No
Age 18 or older *
Yes
No
Education *
Early Childhood Education Units
Employment History (dates and contacts)
Please list any dates or times that you are not available to work.
Personal References (phone numbers)
Three words that describe your personality
What importance do these three traits play in working with kids?
What is your personal philosophy towards camp?
What makes a successful youth program?
Please list any special training, education or certifications you have.
Check any talents and interests you would bring to the program.
Rock climbing
Sewing
Soccer
Cooking
Swimming
Painting or Drawing
Football
Puzzle’s and Challenges
Baseball
Arts and Crafts
Basketball
Scrap booking
Hockey
Public speaking
Volleyball
Music
Group Games
Dance
Paintball
Computer and Internet
Fitness
Health and Nutrition
Sign Language
Science and Nature
Photography / Video
Camping
Fishing
Hiking
Foreign Language
Lifeguard
Woodworking
Skateboarding
Rollerblading
Snowboarding or Skiing
Please list any talents not mentioned above.
How did you here about us?
Have you ever been convicted of a crime, including sex related or child abuse offenses? *
Yes
No
If yes to conviction, please explain.
In checking the box below I declare that the above information I have provided is true and I can provide documentation to verify the information if needed. *
Verify true.