2017 4-H Teen Leader Camp Application
Due: Monday, November 7, 2016 NO LATE APPLICATION ACCEPTED
Return completed application to: Howard County 4-H Camp
3300 N. Ridge Rd, Suite 240, Ellicott City, MD 21043
ALL APPLICANTS MUST ATTEND ONE TRAINING
November 19th 9am – Noon or November 19th 1-4p.m.
A link to register for the training will be emailed with
confirmation of receiving your application in our office.
Interviews will be held on Saturday, December 17th
Name: ______Email: ______
Address: ______
Home Phone: ______Cell Phone: ______
Parent/Guardian Name: ______Cell Phone: ______
Birth Date: ______Age (as of 1/1/17): ______Number of years you have previously attended Howard County 4-H Camp: ______
What other camps have you attended? ______
Leadership positions held at camp, 4-H, school, or in community. Please include as much information as possible:
Position applying for – please check:
Group Leader (4-H age 16 & up with 2 years prior experience as a Leader)Leader (4-H age 15 and up)
Assistant Leader (4-H age 14 and up)
Leaders In Training (LIT 4-H age 13 and up or 1st year)
What experience have you had working with youth?
How would camp benefit by having you as a part of our camp staff?
What do you feel you would gain from this camp leadership experience if accepted? If you were part of the leadership team in 2016, what did you gain from that experience?
Why are you applying for a camp staff position?
Please check the training and/or certificates you already have, if accepted for a position; a copy of your certificates must be placed in your file.
Red Cross First Aid CertificationWater Safety Instructor or Life Guard
Know basic Sign Language
Please attach a Resume with your application.
The University of Maryland Extension programs are open to any person and will not discriminate against anyone because of race, age, sex, color, sexual orientation, physical or mental disability, religion, ancestry, national origin, marital status, genetic information, political affiliation, and gender identity or expression.