STAFF APPLICATION FORM

Name *:   SSN:
                 First     Last


Permanent Address

Address *:

City *:

State *:

ZIP *:

Phone Number:

Email:


Temporary or Business Address

Address:

City:

State:

ZIP:

Phone Number:



Education (most recent school first)

Years:

School:

Major:

Degree Granted:

 

Years:

School:

Major:

Degree Granted:



Past Employment (List previous two summers or years, most recent first)

Dates:

Employer:

Address:

Phone:

Nature of Work:

Supervisor:

Reason for Leaving:

 

Dates:

Employer:

Address:

Phone:

Nature of Work:

Supervisor:

Reason for Leaving:

 

Dates:

Employer:

Address:

Phone:

Nature of Work:

Supervisor:

Reason for Leaving:



Montessori Experience

Instructor       

Years:   

Student       

Years:   


Camp Experience

Dates:

Camp:

Director:

Address:

Camper or Staff:

 

Dates:

Camp:

Director:

Address:

Camper or Staff:

 

Dates:

Camp:

Director:

Address:

Camper or Staff:



References (Give names and addresses of 3 persons (not relatives) having knowledge of your character, experience, and ability)

Name:

Address:

Phone:

 

Name:

Address:

Phone:

 

Name:

Address:

Phone:



What type of position do you want at Camp Indecon?

Position:   

    

Salary desired:   

Dates available:   

From To


In the following list, select numeral "1" before those activities you can organize and teach as an expert; "2" for those activities in which you can assist in teaching; and, "3" for those which are just your hobby: "C" for those in which you have current certification and attach a copy of your certification card.

Adventure/Challenge
Climbing/ Rappelling
Ropes Course
Spelunking

Arts and Crafts
Basketry
Ceramics
Jewelry
Leather Work
Macrame
Nature crafts
Sketching
Painting
Photography
Weaving
Woodworking

Camp Craft/Pioneering
Camp Craft
Hiking
Orienteering
Outdoor Cooking
Overnight
Mountaineering

Dancing
Ballet
Folk
Social
Square
Tap

Dramatics
Creative
Play Directing
Skits & Stunts

Music
Lead Singing
Instruments
     
     

Nature
Animals
Astronomy
Birds
Conservations
Flowers
Forestry
Insects
Rocks & Minerals
Tress & Shrubs
Weather
Gardening
Animal Care

Sports
Archery
Backpacking
Badminton
Baseball
Bicycling
Fishing
Golf
Gymnastics
Horseback Riding
Informal Games
Ping Pong
Riflery
Skating
Soccer
Softball
Tennis
Track & Field
Volleyball
Wilderness Trips

Water Activities
Canoeing/Kayaking
Diving
Rowing
Sailing
Swimming
Lifeguard
Synchronized Swimming

Miscellaneous
CPR
Emergency Care
First Aid
Campfire Programs
Evening Programs
Storytelling

What contributions do you think you can make at Camp Indecon? 

Describe any specialized training you may have that may have a bearing on the position(s) for which you are applying.

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 the camp.  I also understand that untrue, misleading, or omitted information herein may result in dismissal regardless of the time of discovery by the camp.

Thank you for your application! A Camp Indecon representative will contact you shortly.

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