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Summer Camp Staff Application
Name:______Date of Application ______
Age: ______Date of Birth ______SS # ______- ______- ______
Address: ______
Street & NumberCityStateZip
Phone: ______Cell ______E-mail ______
Position you are applying for: Professional Counselor – Counseling experience
Group Assistant – no counseling experience
Internship – check off if you are also seeking internship as an assistant
Volunteer Experience
CampExperience
Have you ever been a camper? If yes, where? ______Year ______
Have you ever worked at a camp? If yes, where? ______Year ______
Education
Please list school attended, degree and date of matriculation
CollegeMajorDegreeDate of Graduation
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GraduateSchoolMajorDegreeDate of Graduation
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Professional Teaching or Leadership Experience
Organization or SchoolPositionYear
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Work History
List Current or previous work employment
Use separate sheet if necessary
EmployerPositionYear
______
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References
Please list three persons, (not relatives) who have knowledge of your character, experience, work habits and ability
Name Title/year knownPhone
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______
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Certifications
Circle if you have:
Child CPR certificationYesNoExpiration Date ______
First Aid certificationYesNoExpiration Date ______
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Brief Summary of your Skills
Please list any activities that you can organize “O” and teach “T” by indicating on the line
___ Art___ Mini Golf___ Storytelling___ Magic
___ Dance___ Basketball___ ModelBuilding___ Woodworking
___ Crafts___ Baseball___ Challenge Ropes
___ Dramatics___Soccer___ Group Games
___ Paper Mache___ Volleyball___ Nature - General
___ Lanyards___Tennis___ Hiking
___ Video Making___ Frisbee___ Fishing
___ Jewelry___ GaGa___ Puppetry
Can you Swim? ______ Average Strong
Comments
If you like, you may include any additional comments about how your skills can be used at CampFriendship
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Have you ever been convicted of a crime? IF yes, please describe. (A prior conviction may be relevant to the job but not automatically bar you from employment). Yes No
Explain:
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Requirements
Staff are required to attend two pre-season in-service training meetings – dates to be announced.
My signature indicates that the information in this application is true and accurate. I also understand that my references will be checked for verification.
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Signature Date
Please send application to: Julie Ziff, LCSW
Center for Psychology and Counseling
1960 S. Easton Road
Doylestown, PA18901
All applications will receive a response. Thank you for your interest in CampFriendship!
Fax: 302-348-3309 e-mail:
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