Camp Program Staff Application

Name
Email:
Birth Date:
Gender
Cell Phone:
-

PERMANENT ADDRESS

Dates/Time Available (at main address)
Main Address:
Main Phone:
-

SCHOOL OR WINTER ADDRESS

Dates/Time Available (at school address)
School Address:
School Phone:
-

EDUCATION

List school name, years attended, major subjects, and degrees granted.

School 1:
School 2:

EMPLOYMENT - for the past two summers or years

List dates employed, employer, employer address & phone, nature of work, supervisor, and reason for leaving.

Job 1:
Job 2:
Job 3:
Indicate any employer you do not wish us to contact and the reason.

CAMP EXPERIENCE

List dates, name of camp, camp address & phone, director, and wether you were a camper, staff, or both.

Camp 1:
Camp 2:

REFERENCES

Give names/addresses of 3 persons(not relatives) having knowledge of your character, experience and ability. List name, address, and phone number.

Reference 1:
Reference 2:
Reference 3:

WHICH POSITION ARE YOU APPLYING FOR?

Dates/Time Available to Work
Are there any reasons you may have difficulty in performing any of the essential elements of the job for which you have applied?
If yes, please explain:

CONSIDERING THE CAMP PROGRAMS AND POSITION APPLYING FOR - Select those activities which you can organize and teach.  Select those activities you feel you can assist in teaching.

Recreation/Outdoor Living Skills

Softball:
Fishing:
Survival:
High Ropes Course:
Soccer:
Field Games:
Orienteering:
Climbing Tower:
Archery:
Volleyball:
Overnight Camping:
Hiking:
Outdoor Living Skills:
Initiative Challenges:

Nature/Agriculture

Marine Life:
Birds:
Forestry:
Pond Life:
Insects:
Gardening:
Woodland Life:
Aquaria Care:
Barnyard Animal Care:
Small Animal Care:
List other nature/agriculture:

Creative Arts

Leather Work:
Lead Singing:
Play Directing:
Painting:
Storytelling:
Skits and Stunts:
Pottery/Sculpting:
Nature Crafts:
Dance (list type):
Instrument (list type):

Waterfront

Swimming Instruction:
Canoeing:
Kayaking:
Snorkeling:
Water-related Games:

Other Activities:

Native American Culture:
Campfire Program:
Evening Activities
List other activities:

CERTIFICATIONS/SPECIAL TRAINING

First Aid, CPR, Life Guard Training, Archery, Ropes Course, etc. Please provide date received and expiration date:
What contribution do you think you can make at camp?
What contributions do you think a well-run camp can make to children?
Are you aware that all employees at Camp Farley are subject to a CORI and SORI check?
Write a brief biographical sketch, including specialized training experience or training in other fields which might have a bearing on the position for which you are applying.
Required*

In accordance with Massachusetts law, summer camps are required to obtain a criminal background report on all staff working with children. Part of the application process will require you to authorize Camp Farley to receive this information about you. I authorize investigation of all statements herein and release the camp and all others from liability in connection with same. I understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery by the camp.

Note: All statements become part of any employee personnel files.