Name *

First Name

Last Name

Phone *

We will text to set up an interview

(###)

###

####

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

School Address

(If applicable)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday *

MM

DD

YYYY

Availability *

Check yes for full week availability (8:30am-2:30pm):

All summer

May 28 - May 31

June 3 - June 7

June 10 - June 14

June 17 - June 21

June 24 - June 28

July 8 - July 12

July 15 - July 19

July 22 - July 26

July 29 - August 2

August 5 - August 9

May we contact the employers listed above for work references? *

Yes

No

Summer camp work involves close contact with children. Have you ever been investigated, arrested or convicted of Child Abuse, Neglect or Related Charges? *

Yes

No

Drug or Alcohol Charges? *

Yes

No

Have you ever been convicted of any other criminal activitiy? *

Yes

No

Camp work requires physically demanding activity including but not limited to hiking, running, lifting and carrying. Do you have any physical limitations that would prevent you from performing the work for which you are being considered? *

Yes

No