Broadstone

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Broadstone

20 August 2008

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Staff Application

Example Using Uniform

Camp Broadstone Online Staff Application

Thank you very much for your interest in working at Camp Broadstone! Please complete the form below to apply for staff positions for our Summer Enrichment Programs for Academically Gifted Children. You may want to type your answers in another program and then paste them into this form. Depending on the position you are interested in, you may receive a supplemental questionnaire containing a few additional questions. Feel free to contact John Paul McNeal if you have any additional questions. Note: Cooks have a separate application process and should call 828-963-4640 for more information.

Positions

Check the box next to the position(s) for which you are applying.

Head Counselor*
Senior Cabin Counselor
Junior Cabin Counselor
Counselor In Training
Day Camp Counselor
Academic Coordinator*
Enrichment Instructor
Head of Adventure Staff*
Adventure Staff
4-Day Trip Coordinator*
4-Day Trip Leader
Camp Nurse*
Intern
Camp Photographer

* = Leadership Team Member

General Information About You

First Name:
Last Name:
Permanent Address (Street Address, City, State, Zip):
School Address:
E-Mail Address:
Phone at Permanent Address:
Phone at School Address:
Cell Phone:
Mail should be sent to which address?	Permanent School until
What will your age be on June 1, 2008 (click here to see minimum ages for each position)?	15 or younger 16 17 18 19 20 21 or older Prefer not to answer
What it your T-shirt size?	S M L XL XXL Prefer not to answer

Summer 2008 Dates

Are you available for all of the training and camp dates for the Summer of 2008?

4 Day Staff Training: May 19-23 (4-Day Staff Only)
Adventure Staff Training: May 26-30 (Adventure Staff Only)
All-Staff Training: June 4-11 (All positions)
Camp Sessions: June 15-27, July 5-Aug. 1 (All positions)

Yes, I am available for all training and camp dates and have no conflicts (graduations, weddings, family reunions, etc.).
No, I have the following conflicts:

Education (High School and beyond)

School Name	Major Subjects	Dates Attended	Current Grade Level / Degree Received

Past Employment (List previous two summers or years)

Dates	Employer/Supervisor	Address	Phone #	Nature of work

Camp Experience

Camp Name	Address	Dates	Camper or Staff?
			Camper Staff
			Camper Staff

References

Give names and contact information of 3 people (neither friends nor relatives) who have knowledge of your character, experience, and ability. You will send each of these people a reference form as well.

Name	E-mail Address	Phone	In what capacity have you known this person?

Certifications

Check the box next to your current certifications and the date that each certification expires.

Standard First Aid	Date Expires:
CPR	Date Expires:
Wilderness First Aid	Date Expires:
Wilderness First Responder	Date Expires:
Instructor Rating-Open Canoe	Date Expires:
Lifeguard Training	Date Expires:
Other (please list)	Type of Certification / Date Expires:

Driving Experience

Driving camp vehicles is required for many of our positions, so we need to know if you are able and willing to drive our state-owned vehicles.

Have you had a valid driver's license for at least three years?	Yes No
Have you had more than one moving violation in past three years?	Yes No
Have you had a DWI in the past three years?	Yes No
Are you willing to drive 12-15 passenger vans?	Yes No

Additional Comments or Questions

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