Camp Foster YMCA
Human Resources Office
1769 260th Ave
PO Box 296
Spirit Lake, IA 51360-0296
PLEASE NOTE: THIS FORM CAN NOT BE SUBMITTED THROUGH THE INTERNET.
Please fill in the entire form, print it to your printer, and mail to the above address. If you need to add any additional information, please write it on a separate piece of paper and include with your application.
SUMMER STAFF APPLICATION PERSONAL INFORMATION
Last Name:
First Name:
MI:
Birthdate:
Present Address:
City/State/Zip:
Phone:
Permanent Address:
City/State/Zip:
Phone:
Gender:
Male Female
E-mail:
Social Security Number:
Mark the LAST year you will have completed in school as of this COMING June:
High School - 9 10 11 12
College - 1 2 3 4
Grad School - 1 2
EDUCATION
High School/College/Trade, etc. Attended
Major Subjects/Degrees
1.
2.
3.
For what career are you preparing?
Are you in school now? Yes No
Please list your Summer availability dates:
FROM: TO:
Please list your Spring Vacation dates:
FROM: TO:
Summarize your extra curricular school activities: Please include group or activity name, your position, and whether this activity was in high school or college:
EXPERIENCE & INFORMATION
EMPLOYMENT: List below your last three jobs beginning with the most recent.
Employer Name
Phone Number
Duties
1.
Employment Dates:
2.
Employment Dates:
3.
Employment Dates:
CAMPING: Have you ever been a camper? Yes No
If yes, what camp(s) did you attend, where was it located, and describe your experience:
STAFF: Have you ever been a member of a camp staff? Yes No If so, list below the camp name, the year(s) you worked there, your position, camp location & phone number:
CAMP PROGRAM SKILLS
Please check the first space for activities in which you have experience. Check the second space if you have enough proficiency to teach.
Some Experience
Profecient to Teach
Canoeing
Horseback Riding
Sailing
Waterskiing
Riflery
Swim Lessons
Ropes Course
Skin Diving
Arts & Crafts
Photography
Nature Instruction
Pottery
Creative Drama
Painting
Archery
Dance
Dance Type:
Music Type:
Swimming Ability: Excellent Good Fair Poor
Other Skills:
Other training, please check:
Water Safety Instructor (WSI)
Expiration Date:
Lifeguard Trainer
Expiration Date:
Lifeguarding (Lifesaving)
Expiration Date:
Standard First Aid
Expiration Date:
CPR
Expiration Date:
Other (Please List):
Please indicate the position(s) you wish to be considered for.
Refer to the Job Description page if needed.
Please answer the following questions in narrative form. If extra space is needed, please continue your response on a separate sheet of paper.
1. Describe your strong and weak points.
2. Explain how you will have a POSITIVE influence on campers this summer.
3. What experiences have had the greatest effect on your thinking and why?
4. Working at camp is "challenging". What will those challenges be for you, and how will you meet or exceed them?
5. List your leisure pursuits and hobbies.
6. If you were a parent, what would you want your child to gain from a summer camping experience?
7. In your opinion, what are some of the vital issues facing young people today in the following age brackets:
8. As a staff member, how can you help children ages 8-16 resolve some of the above listed issues?
9. List your goals for next year.
Have you ever been previously convicted of a felony, misdemeanor, child abuse, or sexual abuse offense?
No Yes
If yes, please indicate the conviction(s), dates, and circumstances.
REFERENCES
Thank you for your time in filling out this application form. Once we have received your completed application, we will mail to you three (3) reference forms to be filled out.
List the three (3) persons you intend to give the reference forms to, and include their Name/Address/Position/Phone
I hereby certify that this application contains no willful misrepresentation, and that the information given by me is true and complete to the best of my knowledge.
