Florida Fish and Wildlife Conservation Commission

OcalaConservationCenter's Outdoor Adventure CampStaff Application

Fill out this form completely. (please type or print)Date of Application______

Name: ______

Last NameFirst NameMiddle NameSocial Security #

Date of Birth: ______Home Phone: ______

Business/ School/ Daytime Phone: ______Cell Phone: ______

What’s the best time to call? ______Email Address: ______

Permanent Address: ______

Street & NumberCityStateZip

College Address: ______Street & Number City State Zip

What position(s)are you applying for? ______Salary desired? ______

Dates available: From: ______To: ______

Are there any reasons you may have difficulty in performing any of the essential functions of the job for which you have applied? Yes No If yes, please explain______

______

All staff must be available for six (6) weeks of camp and one week of training.7 weeks total We’ll take the week of July 4th OFF.

Education:

Level / Years / School / Major Subjects / Degree Granted
High School
College
Other

Past Employment (List previous two years)

Dates / Employer / Address/Phone / Type of work / Supervisor / Reason for leaving

CampExperience:

Dates / Camp / Director / Address/Phone / Nature of work / Camper orStaff?

References:(Please give the names, address and phone numbers of 3 persons, not relatives, having knowledge of your character, experience and ability)

Name / Address (Street, City, State, Zip) / Phone (Area Code) Number

Please circle the “T” if you can teach the activity, circle the “A” if you can assist but do not feel qualified to lead the activity.

Environmental EducationTASwimmingTA

Camping SkillsTACanoeing/KayakingTA

Outdoor SportsTAFishingTA

TeamBuilding ActivitiesTAArcheryTA

Hunter SafetyTARifleryTA

BackpackingTAArts & CraftsTA

Survival SkillsTAStory TellingTA

Min, Impact CampingTASinging/Leading songsTA

Campfire ActivitiesTAHikingTA

Check the area that you have current certification:

□ CPR/First Aid□Wilderness First Aid□ Water Safety & Rescue Breathing

□ Lifeguard□Canoe Instructor□ Hunter Safety instructor

□ Small craft Instructor□Other ______

Do you have a valid driver’s license? Yes No A Commercial license? Yes No If yes: What State ______

License # ______

Endorsements or Limitations;______

When are you available for an interview? ______

I authorize investigation of all statements herein and release the camp from liability in connection with same. I also understand that untrue, misleading or omitted information herein may result in dismissal, regardless of the time of discovery by the camp.

Signature of Applicant ______Date: ______(All statements become part of employee personnel files.)

Return completed applications to: Will Burnett, Director

OcalaConservationCenter and Youth Camp

7325 NE 170 Avenue

Silver Springs, FL34488

Additional information is provided at

“Providing the opportunities to begin friendships that can last a lifetime”

7325 NE 170th Ave • Silver Springs • FL • 34488 PHONE: (352) 625-2804

PO Box 2615 • Silver Springs • FL • 34489 FACSIMILE: (352) 625-0333

Life is better in the Outdoors! • • • Visit us at: OcalaAdventureCamp.comPage 1 of 2