Complete and submit the application below:

Today's Date

Name
MaleFemale

E-mail:

Date of Birth
Social Security #

For the Position of:
Home Address

School Address

Home Telephone

School Telephone
      
References(Please include Name, Phone Number and Work Relationship)
Reference One
 Reference Two
   
Education
University/College

Major

Years Completed by June
 Do you hold any of the following certificates?
LGT
First Aid
RTE
Emergency Response
EMT
Adult CPR
BLS CPR/FPR
WSI
ARC Small Crafts
Other:

Activities: In the following select

 1 - for those activities you can organize and teach as an expert.
2 - for those activities you can assist in teaching.
3 - for those activities you have useful experience as a participant.

Land Sports

Water Sports

Arts & Crafts
1 2 3 Archery 1 2 3 Swimming 1 2 3 Ceramics
1 2 3 Baseball 1 2 3 Diving 1 2 3 Drawing
1 2 3 Basketball 1 2 3 Scuba 1 2 3 Fiber Arts
1 2 3 Field hockey 1 2 3 Synch-Swim 1 2 3 Graphic Arts
1 2 3 Golf 1 2 3 Water Polo 1 2 3 Handicrafts
1 2 3 Lacrosse 1 2 3 Lifeguard Yr. 1 2 3 Jewelry
1 2 3 Mountain Biking  1 2 3 Water Ski 1 2 3 Leather
1 2 3 Roller Hockey   1 2 3 Macramé
1 2 3 Rugby Boating 1 2 3 Photography
1 2 3 Softball 1 2 3 Canoeing 1 2 3 Darkroom (B/W)
1 2 3 Team Handball 1 2 3 Kayaking 1 2 3 Printing
1 2 3 Tennis 1 2 3 Sailing 1 2 3 Rocketry
1 2 3 Track & Field 1 2 3 Windsurfing 1 2 3 Sewing
1 2 3 Volleyball 1 2 3 Motorboat 1 2 3 Tie Dying
1 2 3 Weights/Fitness 1 2 3 Small Craft Cert. 1 2 3 Woodworking
Entertainment's    
1 2 3 Directing Nature & Pioneering Dance
1 2 3 Costuming 1 2 3 Animal Care 1 2 3 Aerobics
1 2 3 Stagecraft 1 2 3 Biology 1 2 3 Choreography
1 2 3 Radio Broadcast 1 2 3 Campcraft 1 2 3 Ballet
1 2 3 Film & Video 1 2 3 Ecology 1 2 3 Folk
Music 1 2 3 Fishing 1 2 3 Jazz
1 2 3 Chorus 1 2 3 Gardening 1 2 3 Square
1 2 3 Song Leader 1 2 3 Hiking 1 2 3 Tap
1 2 3 Piano 1 2 3 Nature Study Miscellaneous
1 2 3 Accompanist 1 2 3 Outdoor Cooking 1 2 3 Group Games
1 2 3 Drums 1 2 3 Ropes Course 1 2 3 Skits
1 2 3 Guitar 1 2 3 Climbimg Tower 1 2 3 Newspaper
Other: Please Explain
Describe your teaching experience and personal standard of proficiency attained in connection with your activity choices. Include all qualifications gained, teams joined, offices held, trophies/honors won, etc.


Describe any previous experience working with children (including previous camp experience - if any).


Describe your outstanding personality and leadership traits as it relates to your relationship with children and/or your peers.


Do you have a valid driver's license? passenter CDL
Other

Have you ever been convicted of a crime more serious than a traffic violation?  Yes No
If yes, explain:


Did you attend a camp as a camper? Yes No Camp YearsCamp Years

PLEASE INDICATE FIRST AND SECOND CHOICE FOR AGE GROUPS
Check age group of campers you prefer for cabin duty:5-7 7-9 9-11 11-13 13-14 14-16

      Check age group you feel best equipped to instruct: 5-7  7-9 9-11 11-13 13-14 14-16

Are you available for an interview in the NYC area? yes no   When?

If not, where and when can we meet you?

The application warrants that the above information is true. Accurate but brief answers are essential.
Statements and references will be carefully checked. Lack of camp experience is no obstacle to this application.

If the information filled out above is correct, click on "Submit Application".
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