SJ Ranch Returning Staff Application

For Office Use Only

Rec______Tel______By______SQ______Int_____

Comments:

NI______H______CS______

Return to: Pat Haines - (860) 872-4742

130 Sandy Beach Rd., Ellington, CT 06029

Full Name ______

Permanent Address ______

City ______State ____ Zip ______

Phone (______) ______

Cell (______) ______

E-mail______

(Please indicate for which dates each address is valid)


Social Security #______

Birthdate ______Sex ______

Are you free to live away for the summer? ______

Do you have health or physical problems which would restrict you from strenuous activity? ______

If yes, please explain ______

______

Have you ever been convicted for any crime, including sex-related or child abuse related offenses? ______

Education

______

High School Years Attended Year of Graduation Major Subjects

Leadership Experience (Previous camp employment, positions with children, coaching or teaching exp.)

Position Age group worked with Dates Group/Employer

______

______

Please list any certifications that you have now or are planning to get. (i.e. first aid, lifeguarding, CPR, riding, archery) with expiration dates

______

Please rate yourself on the following (on a scale of 1 to 10):

___ Sense of humor ___ Hard worker ___ Ability to work alone ___Ability to work in a group

___ Leadership ability ___ Following ability ___ Skill with children ___ Creativity

___ Organizational skills ___ Friendliness ___ Punctuality ___ Reliability

In which area(s) of camp would you prefer to specialize? Mark choice 1st, 2nd, 3rd , etc. , or simply check those areas you are interested in:

___Waterfront ___Sports ___ Kitchen ___ Arts & Crafts ___Scheduling

____Barn ___Riding ___Barn Director ___Movies ___Office

____Slideshow ___Maintenance ___Dramatics ___Games Salary Desired ______

Do you have any concerns about working at camp? ______

______

Please indicate how many non-horse and non-camper hours per day you are willing to do (i.e. kitchen, cleaning, office, maintenance) ______

______

Do you have any suggestions to make staff training week better? ______

______

Please indicate your preference as far as working the entire summer or just 1, 2 or 3 sessions. Also which sessions? ______

Are you willing to work the entire summer?______Are you willing to work a partial summer?______

Please rate any of the following activities that apply, putting a “3” before those activities that you have some skill at, and enjoy; a “2” before those activities in which you are highly skilled or knowledgeable; and a “1” before those activities which you could organize and feel confident teaching. Please star those activities that you would like to teach at camp.

Arts and Crafts

___Jewelry making

___Leather work

___Macrame

___Nature Crafts

___Painting

___Photography

___Scrap Crafts

___Sketching

___Wood Carving

List craft projects that you could teach:

______

______

______

______

Music

___Singing

___Guitar

___Square Dancing

___Folk Dancing

______
Campcrafts

___Fire craft & safety

___Outdoor cooking

___Overnight camping

______

Dramatics

___Acting Games

___Skits and Stunts

___Clown Arts

___Video

___Story Telling

______

List Nature activities that you could lead:

______

______

List Night Programs that you could lead:

______

______

______

______

______


Sports

___Archery

___Badminton

___Basketball

___Gymnastics

___Ping Pong

___Soccer

___Softball

___Tennis

___Volleyball

______

______

Games, etc.

___Jumprope

___Foursquare

___Frisbee

___Juggling

___Stilts

___Sign Language

___Campfire programs

______

______


Waterfront

___Canoeing

___Rowing

___ Swimming

___Lifeguarding

Riding

___Beg. Riding

___Int. Riding

___ Adv. English

___Adv. Western

___Beg. Jumping

___Adv. Jumping

___ Dressage

___ Horse Care

______

List Barn programs that you could teach:

______

______

______

______

______

Other skills-Do you have any interest, expertise, or experience in any of the following areas?

Kitchen--Cooking, baking, meal prep or cleanup? ______

Maintenance— chores, painting, gardening, or cleaning? ______

Office – i.e. filing, slideshow, e-mails, typing, stuffing? ______

Are you willing to go on an overnight with campers?______

Please fill in your ideal schedule:

7AM______

8AM______

8:30______

9AM______

10AM______

11AM______

12Noon______

1PM______

2PM______

3PM______

4PM______

5PM______

6PM______

7PM______

7:30______

8:30______

9:00______

On a separate sheet please indicate why you are interested in working here again and what you hope to bring to the job this summer.