2015 APPLICATION FOR SUMMER CAMP EMPLOYMENT

Transcription

1 2015 APPLICATION FOR SUMMER CAMP EMPLOYMENT PLEASE PRINT OR TYPE YOUR ANSWERS AND RETURN THIS FORM TO CROSSROADS OF AMERICA COUNCIL, 7125 Fall Creek Road North, Indianapolis IN, 46256, or to NAME: POSITION DESIRED: Last First Middle BELZER DAY CAMP, (Northeast of Indianapolis, 7 weeks) (6/1/2015-7/24/2015) WEBELOS ADVENTURE CAMP, (Camp Kikthawenund) (Anderson; resident staff, 7 weeks) (5/30/2015-7/18/2015) RANSBURG SCOUT RESERVATION, (Bloomington; resident staff, 10 weeks) (5/24/2015-8/1/2015) KRIETENSTEIN SUMMER CAMP, (Poland; resident staff, 6 weeks) (5/30/2015-7/19/2015) The purpose of Scout Camp is what happens inside the campers. What they take home with them in their memories, in their new purposes, in their improved or newly acquired skills, in their friendships, in their appreciations. It is the mission of the Boy Scouts of America to serve others by helping to instill values in young people and in other ways to prepare them to make ethical choices over their lifetime in achieving their fullest potential. The values we strive to instill are based on those found in the Scout Oath and Law. WHY DO YOU WANT TO WORK AT ONE OF OUR SCOUT CAMPS? PERSONAL PERMANENT ADDRESS: Number, Street City State Zip ADDRESS: CELL PHONE: ( ) TEMPORARY ADDRESS: (College) Number, Street City State Zip HOME TELEPHONE :( ) COLLEGE TELEPHONE ( ) NAME YOU WOULD LIKE TO GO BY DATE OF BIRTH: ARE YOU A CITIZEN OF THE U.S.? Emergency Contact: NAME ADDRESS TELEPHONE NUMBER OF NEAREST RELATIVE: DO YOU HAVE A VALID DRIVERS LICENSE? WHAT STATE? APPROXIMATE DATE OF AVAILABILITY FROM: TO: SALARY EXPECTED: $ PER WEEK VACATION REQUEST (Time that you need off) PREVIOUS SEASONS ON CAMP STAFF: SHIRT SIZE: HAVE YOU EVER BEEN CONVICTED OF ANY FELONY? HAVE YOU EVER BEEN CONVICTED OF CHILD ABUSE OR UNLAWFUL SEXUAL OFFENSE?

2 EDUCATIONAL HISTORY CIRCLE NUMBER OF YEARS COMPLETED IN EACH CATEGORY MIDDLE SCHOOL GRADE HIGH SCHOOL YEAR GRADUATED COLLEGE NAME AND LOCATION DEGREE YEARS LEFT MAJOR MINOR POST GRADUATE NAME AND LOCATION DEGREE YEARS LEFT IMPORTANT COURSES SPECIAL SCHOOLS, NAME AND LOCATION DEGREE YEARS LEFT IMPORTANT COURSES AWARDS, SOCIETIES, SCHOLARSHIPS AND SCHOLASTIC HONORS CERTIFICATES OR LICENSES USEFUL TO CAMP LIST INTERESTS, ACTIVITIES, AND HOBBIES LIST LEADERSHIP ROLES CAMPING EXPERIENCE SCOUTING BACKGROUND CURRENTLY REGISTERED? DISTRICT: UNIT # SCOUT RANK FIRECRAFTER RANK ORDER OF THE ARROW STATUS NAME OF CAMP LOCATION YEARS CAMPER OR STAFF

3 PLEASE CHECK AS FOLLOWS: SPECIFIC SKILLS XXX Can assume full responsibility. XX Proficient and can lead or direct or teach. X Some knowledge and can assist in leading. Camping Athletics and Games Kayaking Backpacking Astronomy Sailing Cooking Ecology CPR Instruction Pioneering Forestry Lifesaving (Certified) Orienteering Nature Swimming Mountainman Mammals Water Sports Camp Craft Animals Basketry Hiking Birds Leatherwork Rappelling Trees Indian Lore Caving Insects Woodcarving Campfire Programs Environmental Services Arts and Crafts Wilderness Survival Mountain Biking Story Telling Archery Canoe Trips First Aid Softball Sail Boarding Group Singing Volleyball Water Skiing Horseback Riding Basketball Canoeing Religious Services Fishing Rowing Instrument Played Riflery Conservation Projects What? Black Powder OTHER Management/Directors Minimum age 21 Assistant Camp Director Aquatics Director Program Director Shooting Sports Director Range Officer (non-director position) Medical Officer Adventure Point Director Assistant Camp Commissioner Assistant Program Director C.O.P.E. Director Camp Commissioner Climbing Director Ranch Director Rifle Range Director Minimum age 18 Aquatics assistant Archery coordinator Assistant Ranger Camp Commissioner Dining Hall Manager/Steward Ecology/Nature Director Handicraft Director Medical Officer Scoutcraft/Outdoor Skills/Adv.Trail Dir Trading Post Floor Manager Training Coordinator BDC Only Baden Powell Director Baden Powell Instructor Dan Beard Instructor POSITIONS Indicate, in order of preference, position(s) in which you feel you are qualified to serve: Webelos KSC Only Eagle Challenge Director Dining Hall Manager Shooting Sports Assistant Den Chief KSC & Archery Director Eagle Quest Director Aquatics Coordinator Firecrafter Director C.O.P.E. Assistant Climbing Assistant Horse Assistant OA Director Quartermaster Venturing coordinator Sports Coordinator KSC, RSR, & WAC Only S.T.E.M. Director WAC Only Assistant Camp Commissioner Assistant Program Director Counselors/Instructors Minimum age 16 Aquatics Archery Ecology/Nature Handicraft Office Manager Scoutcraft/Outdoor Skills/Adv. Trail Trading Post Clerk BDC Only WAC & KSC Only Kitchen/Dining Hall Staff KSC & Eagle Quest Firecrafter Instructor OA Coordinator OA Area Counselor Horse Program Sports RSR, WAC, & KSC Only S.T.E.M. Minimum age 15 & in High School Counselor-In-Training (Resident Camp) Instructor/Aide (Day Camp) Minimum age 14 (BDC only) Counselor-In-Training (Day Camp) NOTE: NOT ALL CAMPS HAVE ALL POSITIONS BDC: Belzer Day Camp

4 KSC: Krietenstein Scout Camp RSR: Ransburg Scout Camp WAC: Webelos Scout Camp

5 Crossroads of America Council Boy Scouts of America OCCUPATIONAL HISTORY PLEASE LIST YOUR LAST THREE POSITIONS HELD, STARTING WITH YOUR MOST RECENT AND WORKING IN REVERSE ORDER REFERENCES NAME OCCUPATION ADDRESS PHONE NAME OCCUPATION ADDRESS PHONE SCOUTMASTER / ADVISOR NAME TROOP / CREW # ADDRESS PHONE (Please attach a Scoutmaster/advisor letter of reference with application or if not a Scout, an employer or character reference letter.) SIGNATURE OF APPLICANT: DATE: FOR OFFICE USE ONLY REF. REC D HOLD POSITION REF. REC D REJECTED SALARY INTERVIEW SCHEDULED RESULTS CONTRACT REC D B-100 Summer Camp Employment Application 2015 B-100 1