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First Name * Last Name *
Home Phone Number Other Phone Number
Home Street Address * Other Street Address
Home City * Other City
Home State * Other State
Home Zip Code Other Zip Code
Home Country Other Country
Social Security Number * Email Address *
* Required for US Citizens
Date of Birth * (MM/DD/YYYY) Gender
Female Male
Are You Married? List Children (age/gender)
Yes No
How Did You Hear About Us?
High School High School Graduation Date (MM/DD/YYYY)
College College Major
Current Year
Driver's License # State Issued
Earliest Date Available Latest Date to Stay
Based on camp salaries which include room and board, how much are you looking to make this summer? (Total for 8-week period.)

Employer's Name: Contact Person:
Phone: Dates of Employment:
Salary:
Employer's Name: Contact Person:
Phone: Dates of Employment:
Salary:

Our staff are hired as either general counselors or specialists in a specific area. In which area are you applying to work?
General Counselor
Specialist
If Specialist, what particular area?
There may be an occasion where we will ask you to help out in a particular area. Consequently, we would like to know if you have a background in any or all of the areas listed below. Please select all of the areas that apply to you.

Please put 1 before the following activities you can organize and teach as an expert, 2 for those activities you can assist in teaching, and 3 for those in which you have had some useful experience.
1 = ability to organize & teach
2 = ability to assist in teaching
3 = some possess some useful experience
1 2 3 N/A Land Sports
Softball
Baseball
Basketball
Soccer
Football
Floor Hockey
Roller Hockey
Ice Hockey
Lacrosse
Volleyball
Track
Jogging
Skateboarding
Golf
Tennis
1 2 3 N/A Gymnastics
Floor Exercise
Balance Beam
Parallel Bars
Vault
Rings
1 2 3 N/A Fitness
Martial Arts
Cheerleading
Boxing
Wrestling
Weight Training
1 2 3 N/A Water Sports
Swimming
Canoeing
Rowing
Kayaking
Sailing
Wind Surfing
Water Skiing
Wakeboarding
Kneeboarding
Motor Boat Driving
1 2 3 N/A Equestrian
English
Western
Dressage
Jumping
Stable Maintenance
1 2 3 N/A Ropes Course
Low stations
High Stations
Rappelling
1 2 3 N/A Outdoor Activities
Mountain Biking
Mountain Boarding
Nature/Ecology
Overnights
Hiking
Fishing
Astronomy
1 2 3 N/A Visual Arts
Drawing
Painting
Cartooning
Calligraphy
Sculpture
Woodwork
Needlepoint
Stained Glass
Candle Making
Clothing Design/Sewing
Fabric Painting
Beading
Weaving
Soft Sculpture
Knitting/Crocheting
Macrame
Tie Dye
Batik
Basketry
Copper Enamel
Metal Work/Welding
Leather
Ceramics
Puppetry
Paper Maché
Line/Wood Cut
Etching
Photo Print-Making
Photography
Screen Printing
Mosaics
Air Brush
Computer Graphics
1 2 3 N/A Dance
Jazz
Ballet
Modern
Hip Hop
Pointe
Tap
Choreography
1 2 3 N/A Theatre
Directing
Script writing
Improvisation
Acting Technique
Stage Combat
Acting for the Camera
Mime
1 2 3 N/A Tech Theatre
Set Design
Set Construction
Properties
Video
Lighting
Sound
Recording
Costuming
Make-up
1 2 3 N/A Circus Acts
Clowning
Juggling
Unicycle
Trapeze
Tightrope
Spanish Web
Tumbling
Adagio
Rolling Globe
Fire Eating
Bicycle Act
Stilt Walking
Hand Balancing
Circus Other
1 2 3 N/A Magic
Close Up
Card
Stafe
Illusion
1 2 3 N/A Miscellaneous
Fencing
Radio Broadcasting
Disc Jockey
Model Railroading
Newspaper
Creative Writing
Rocketry
Computer Programming
Computer Maintenance
1 2 3 N/A Maintenance
Carpentry
Painting M
Lawn Care
Electric
1 2 3 N/A Kitchen
Food Service Mgmt
Chef
Janitorial
Pot Wash
Music
Instrument A
Years Played A
Instrument B
Years Played B
Medical Staff
Physician
PA
RN
LPN
EMT
Please list any certifications that you hold and their expiration dates: (i.e. Red Cross)
Have you ever been convicted of a felony or misdemeanor? If so, please explain:
No Yes
Have you ever been involved in an incident involving sexual or physical abuse? If so, please explain:
No Yes
Do you smoke? No Yes
Please use the space below to write a brief paragraph why you would like to work at camp:
Please list two references below:
Name:
Relationship:
Telephone:
Name:
Relationship:
Telephone:
Any additional information we should know in considering your application?

Age group of campers you prefer to bunk with:
6-8 9-11 12-13 14-16 Flexible

PLEASE BE AWARE THAT WE CONDUCT BACKGROUND CHECKS ON ALL EMPLOYEES
Give your application about a week to be processed in our office. Then follow up with a phone call if you are seriously interested in working with us this summer.