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Online Application for Staff

STAFF APPLICATION

* First Name:

* Last Name:

* Email:

* Social Security #:

* Position Applying For:

* Address:

* City:

* State:

* Zip Code:

* Home Phone:

* School Address:

* School City:

* School State:

* School Zip Code:

* School Phone:

* How did you hear about us?

Optional Information

Age:

Height:

Weight:

Gender:

Marital Status:

Children:

Ages:

Family required at camp?

Physical Limitations:

Do You Smoke?

Educational & Occupational Background

* Schools Attended
(HS & College)
Years / Degree / Major

* Previous Camp Employment:
Camp / Position / Years / Salary / Addr. & Phone

* Related Work Experience:
Employer / Duties / Years / Salary / Addr. & Phone

* Community Group Affiliation
(JCC, "Y", Youth Org):
Organization / Years / Involvement

Skills and Experience

We would like to know about your skills in certain areas. Please read the following list of activities. Then, in the boxes below, list activities you are familiar with and activities that you can teach or lead.

Athletics:
Softball
Basketball
Archery
Indoor Games
Soccer
Gymnastics
Golf
Hockey
Tennis
Volleyball

Music :
Leading Songs
Instrument(specify)
Guitar
Piano
Other

Cultural Activities:
Oneg Shabbat
Israeli Dancing
Leading Services

Waterfront:
WSI
Lifeguard
Lifeguard Trainer
Small Crafts Instr.
CPR Cert.
EMT
Sailing
Canoeing
Kayaking
Windsurfing
Swimming

Other Areas:
Computers
Newspaper
Typing
Photography (B/W)
Maintenance

Kitchen :
Cooking
Baking

Arts & Crafts:
Ceramics
Wood Working
Sculpture
Copper Enameling

Dramatics :
Creative
Stage Craft
Costuming
Other

Outdoor Life:
Nature
Camp Craft
Outdoor Cooking
Camp Fires
Farming
Overnight Hikes
Ropes Course

* Familiar:

* Teach or Lead:

Background Information

* Do you have a drivers license?

If so, which state:

* Have you ever been charged with committing an act of physical, sexual, or any other type of child abuse?

* Have you ever been convicted of a misdemeanor?

* Have you ever been convicted of a felony?

If the answer is Yes to any of the above 3 questions, please explain:

* Describe any interests or hobbies you have:

* Why do you want to work at Camp Poyntelle / Lewis Village?
(Please include any special skills, talents, work with children, etc.)

* Please give three references that we can contact
(do not include friends or relatives)
Name / Relationship / Address / Phone

PLEASE READ THE FOLLOWING INFORMATION:

I certify that all the statements and information on this application are accurate and complete, and I understand that any employment offer is based upon the accuracy of this information. Any false statements, omissions or inaccuracies of this application will be just cause for my disqualification or dismissal.

By checking this, I understand and agree to the above paragraph