Counselor Application

First Name

Last Name

Gender
 Female Male

Date of Birth (mm-dd-yyyy)

Current Address

Permanent Address (if different from current)

Phone

Cell

Email

How did you learn about us?

The camp season will run from June 20– August 20. Please give your dates of availability.

Please note that applicants available for the full season are given preference.

Are there any reasons you would have difficulty performing the essential functions of the job for which you are applying?

If hired, would you desire or need housing for any person other than yourself at camp? Who and how many?

Have you ever been charged or convicted of any crime, including sex-related or child abuse related offenses?

As a summer camp for children, we encourage healthy choices in our campers and staff. Are you comfortable abstaining from tobacco and alcohol for periods up to 7 days?

Qualifications/Certifications:
Please check any and all that apply.
 First Aid CPR Waterfront Lifeguard Training Pool Lifeguard Training Water Safety Instructor Boat certifications/Licenses

Please specify Boat certifications/Licenses

General Experiences in our skill areas, with children and at camp:
Please tell us about yourself and your experiences with water activities, wilderness experience, sport skills:

Have you had any previous camp experience either as a camper or counselor – please explain:

What training and/or experience do you have with children?

What contributions do you think you can make at camp?

What is your vision of a well run camp and how it affects the staff and the campers?

Skills:
The following is a list of activities that we will offer at camp this summer. Please mark any and all activities you have experience in and feel comfortable leading instruction for children.
 Soccer Sculling Mountain Biking Canoeing Tennis Sailing Design Build (brick oven, boats, rustic furniture) Archery Field Golf Wilderness (trips, hikes, orienteering) Arts & Crafts Field Games (like kickball, softball, basketball, volleyball, four-square, etc.) Running Team building activities (endurance, ironman, etc.)

Education:
Please list high school and college years along with concentration areas:

Past Employment:
Include any camp, coaching and teaching experiences if any.(Employer/Position or Nature of Work/Contact)

References:
Please list three people we may call that have experience with you as a teacher, employer, coach, neighbor, volunteer, etc.(Name/Position/Phone)

I authorize investigation of all statements herein 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 and that any agreement to the contrary must be in writing and signed by the Director of camp. I also understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time or discovery by the camp. By signing below, I understand and agree to the conditions stated above.

Please submit the form if you agree to the above. Thank You.