Staff Application

CAMP PROGRAM >>STAFF APPLICATION

	Summer Camp Employment Application

	Personal Information

	Last Name:	First:		Middle:		Gender: M F

	Present Address:	City:		State:	Zip:

	Present Phone: (include area code)	Cell:		Email:

	Permanent Address:	City:		State:	Zip:

	Permanent Phone:	Age as of June 1:	At least 16 At least 18 At least 21

	Referred to Joy by:

Check all positions for which you are applying below

Resident Camp		Day Camp			Special Needs Day Camp Staff
	Senior Counselor		Senior Counselor			Special Needs Coordinator
	Junior Counselor		Junior Counselor			Special Needs Aide
	Teen Counselor (River Village)		Teen Counselor
	Lifeguard		Resource Staff
	Nurse		Adventure/Teen Director		What age group would you prefer to work with?
			PreTeen Counselor			7-8
	Resource Staff zone:		Day Camp Program Director			9-10
	Discovery Adventure Creative		Day Camp Director			11-12
	Unit Leader:					13-15
	Purple Orange Green Teen
	Support Roles:
	Agency Program Director Teen Program Director Mediation Specialist Medical Program Director LIT Director Pool Director
	Senior Counselor Program Specialist (check at least two program areas you would like to lead):
	Music Nature Drama/Dance Sports Survival/Myth Busters Fishing/Pond Mountain Biking Swim Lessons Photography
	Other:
	Please expand on the two activities that you feel you are most qualified to teach and why:


CAMP DATES: Please check the dates you are available
	Resident Camp		Dates	Day Camp
	Full Staff Training		May 31- June 5	Full Staff Training
	Boys and Girls Club		June 8-12	Day Camp 1		Additional training required for
	Foster Week		June 15-19	Day Camp 2		support and resource staff to be
	Agency Week		June 22-26	Day Camp 3		named later
	Agency Week/MDA		June 29-July 3	No Day Camp		******
	Core Camp/Just Community/Heart Camp		July 6-10	Day Camp 4
	Children's Hospital		July 13-17	Day Camp 5
	Amputee/Wekandu		July 20-24	Day Camp 6
	Police Camp/Reunite		July 27-31


References:
	List three business/work, school or personal references who are not related to you.
	Name	Relationship (example: Supervisor)	Phone	Years Known
1.
2.
3.

List any certifications you have: (examples: Lifeguard, 1st Aid, CPR & expiration date)


VOLUNTARY DISCLOSURE STATEMENT:
	Have you ever been convicted of any sexual, physical, or emotional child abuse, any crime relating to children, or any other crime (not including minor traffic violations)? Yes No

Additional Questions

1.)	Why do you want to work at Camp Joy?


2.)	What are some of your strengths that would make you stand out from other applicants?


3.)	This job requires extensive physical activity. Would you be able to fulfill these requirements for periods of six hours or more? Would you be able to sustain this level of energy week after week for up to ten weeks?

4.)	Briefly describe a time where you did something special for a child.


5.)	Share with us a time where you have dealt with a challenging situation with a child and how you handled it.