Prince William County H Junior Camp Counselor Application

Prince William County 2016 4-H Junior Camp Counselor Application Camp Dates: July 17-21, 2016 I am applying to be a Counselor-in-Training (must turn 14 by July 31, 2016) I am applying to be Camp Counselor (must turn 14 by January 1, 2016) I am applying to be a Senior Counselor (must be a graduating senior in 2016) NAME: HOME ADDRESS: APPLICANT E-MAIL ADDRESS: PARENT E-MAIL ADDRESS: HOME PHONE: APPLICANT CELL PHONE: DOB: / / Gender: M F T-SHIRT SIZE (ADULT): Small Med Large X-Large XX-Large RETURN THIS FORM AND SUPPORTING DOCUMENTS BY JANUARY 29, 2016 at 4 PM, TO: MaryBeth Lerch, 4-H Youth Educator VCE-Prince William County Office 8033 Ashton Ave Suite 105 Manassas, VA 20109-8202 - 1 -

I. JOB DESCRIPTIONS CAMP COUNSELOR JOB DESCRIPTION Be a leader in developing a wholesome camp spirit: o Be friendly to everyone o Learn and use first names o Set a good example o Help the campers feel at home o Encourage campers to participate in all activities; to take care of equipment and 4-H Center property, etc. o Respect campers right to have ideas o Bring out the hidden talents of campers o Go over the camp schedule with campers as often as necessary o Carry out instructions of Camp Director(s) Preside at meals: o Inform campers of procedures used in meal service and clearing of tables o Lead and direct table conversation Give special attention to: o Seeing that no one is left out o Encouraging good eating habits and personal hygiene o Getting campers to various locations on time o Promoting safety at all times o Getting quiet after lights out o Encouraging every camper to be considerate of his/her fellow campers and staff o Promote the six Pillars of Character: trustworthiness, respect, responsibility, fairness, caring, and citizenship Serve as a class assistant or helper and/or teach a class Assist with a group of campers (sometimes called a pack ) Assist with recreation, evening programs and campfire activities Be responsible to the Camp Director(s) or the person he/she designates Help to evaluate camp on the basis of the camp objectives SENIOR COUNSELOR JOB DESCRIPTION All duties listed above for Camp Counselor and the following additional items: Serve as a role model for campers, Counselors, and CITs Provide support, encouragement, and guidance to Counselors and CITs Facilitate communication between the adult staff and the Counselors and CITs Attend daily meetings with the Camp Director(s) Work with the Camp Director(s) and Extension Agent(s) to communicate information about the program to Counselors and CITs (i.e., schedule changes, disciplinary issues, recognition) Report lodge maintenance needs to Camp Director(s) COUNSELOR-IN-TRAINING (CIT) JOB DESCRIPTION Assisting camp counselors with their responsibilities Being able and willing to treat each camper, staff person, and peers with respect and dignity at all times Attending and participating in classes and activities designed to provide 4-H camp CIT s with training Demonstrating familiarity with 4-H center rules and policies and being willing to accept responsibility for enforcing those rules and policies Setting a positive role model for boys and girls at all times during 4-H camp, as well as for the staff working with the 4-H camping event Providing for the safety and well-being of each camper at all times - 2 -

II. EXPERIENCE 4-H Experience (Years as): Member Camper CIT Counselor A. LIST YOUR OTHER LEADERSHIP EXPERIENCE (4-H, SCHOOL, COMMUNITY, CHURCH, and CLUBS): Date Name of Organization Leadership Role(s) B. LIST ACHIEVEMENTS & RECOGNITION YOU HAVE RECEIVED (4-H & OTHERS): Date Achievement/Recognition C. LIST YOUR HOBBIES & INTERESTS: D. LIST THREE OF YOUR OUTSTANDING CHARACTERISTICS THAT WOULD ENABLE YOU TO BE AN EFFECTIVE COUNSELOR/CIT: 1. 2. 3. - 3 -

III. SKILL RATINGS FOR COUNSELOR & SENIOR COUNSELOR APPLICANTS ONLY Please rank you willingness to help with the below classes in order 1-10. Keep in mind your knowledge or skill level is each area. Air Rifle Fishing Newspaper Swimming Archery Gardening Outdoor Cooking Tennis Arts & Crafts High Ropes Outdoor Living Tye Dye Canoeing Horsemanship Skills Low Ropes CIT Multimedia Project MAKE Crocheting Natures Window Performing Arts Is there a class you would like to teach? IV. COUNSELOR/CIT INTERVIEWS All first year Counselor/CIT applicants are required to undergo an interview. This year, interviews will not be required for those who have served as a counselor previously. Interviews will be held at the Extension Office located at 8033 Ashton Ave Suite 105, Manassas, VA or via phone. Interviews will be scheduled upon notification of acceptance and will take place January 27-February 3, 2016. V. ESSAY (REQUIRED) COUNSELOR & CIT APPLICANTS: Attach a sheet describing in at least 100 words why you would make a good Counselor/CIT. SENIOR COUNSELOR APPLICANTS: Attach a sheet describing in at least 100 words why you would make a good Senior Counselor. Describe an experience in which you have used your leadership skills to overcome a difficult situation. Offer two suggestions for improving any aspect of the 4-H camping program. VI. REFERENCES 1. HAVE YOU EVER BEEN CONVICTED OF ANY CRIMINAL OFFENSE AND/OR HAVE YOU BEEN SUSPENDED FROM SCHOOL IN THE PAST 24 MONTHS FOR ANY REASON? NO YES (If yes, you must attach a letter of explanation) 2. Attached you will find two reference forms. Give these to two people who can attest to your ability to be a counselor/cit. Have your reference complete the form, place in a sealed envelope, and sign across the seal, and return to you. These documents must be submitted with your application. - 4 -

VII. AGREEMENT COUNSELOR/SENIOR COUNSELOR APPLICANTS - check ALL boxes to indicate your understanding and agreement CIT APPLICANTS - check only the last two boxes to indicate your understanding and agreement If selected as a 4-H Counselor/Senior Counselor: *I agree to attend the Teen and Adult Leader Training (TALT) to be held Saturday and Sunday, March 5-6, 2016 at the Northern Virginia 4-H Center. (Registration information will be supplied upon acceptance). *I agree to attend all local training sessions unless I have specifically made other arrangements in advance with the 4-H Camp Director. (Additional training dates will be announced after all counselor/cit interviews have been conducted. Generally, there are two local sessions for counselors: one in April and one in May, followed by a combined training with Stafford County counselors in July.) If selected as a 4-H Counselor/Senior Counselor or CIT: *I understand that failure to attend the required training sessions, unless specifically excused by the 4-H Camp Director, may result in my dismissal as a 4-H CIT/Counselor/Senior Counselor. Two local training sessions for CIT s will be held: one in April and one in May. *I agree to uphold the camp rules and procedures and to abide by the 4-H Code of Conduct during the entire camp week. I will conduct myself as a responsible young adult. Applicant Signature *I give permission for my child to apply to be a 4-H Camp Counselor/CIT and will support his/her attendance at the required training sessions. Parent Signature *A link to complete online enrollment, youth health history form, and code of conduct will be sent upon acceptance. - 5 -

4-H Camp Counselor Reference Form for (Teen Applicant s Name) Reference s Name: Relationship to Applicant: 1. How would you rate the applicant s following personal traits? Trait Extraordinary; Top 2% Excellent; Top 10% Good; Top 25% Fair Poor No Basis for Judgment Sense of responsibility Dependable; gets the job done and follows through on commitments Follows directions and procedures Charismatic; connects well with people, especially children Participates fully in all activities Strong Character: responsible, respectful, caring, trustworthy Acts as a team member and cooperates with others Takes initiative; seeks out tasks to complete or ways to help Maintains positive attitude, even in stressful situations Shows a willingness to learn and appreciates feedback to improve Listens well and actively Shows good appearance, wellgroomed, dresses appropriately Is friendly and warm toward others Uses common sense Solves problems, finds solutions Is flexible/adaptable; can go with the flow Respects authority; takes directions from adults Behaves and performs well; has no school or legal record or other disciplinary action Refrains from gossip and drama in peer groups

(more information on back of page) 2. What are the applicant s best three qualities that make him/her a good candidate to be a camp counselor? 1. 2. 3. 3. What is the applicant s biggest weakness or area of need for improvement? 4. Would you hire the applicant to supervise your children and would you hire him/her to work for you in a camp setting? Yes No Comments: 5. What else should we know about the candidate? Once complete, please place the reference form in a sealed envelope, sign across the seal, and return to the applicant. If you prefer, reference forms can be mailed to: MaryBeth Lerch VCE-Prince William County 4-H 8033 Ashton Ave, Suite 105 Manassas, VA 20109-8202