2021 Staff Application Form (Returning)

2021 STAFF APPLICATION FORM *Returning Staff*

Including Staff who were hired for the 2020 season
General Information
Name: *

First Name Last Name
E-mail Address: *
Mailing Address: *

Street

Street Address Line 2

City State/Province

Postal/Zip Code Country
Cell Phone Number: *
Age (as of July 2021): *
Birthday: *

Month Day Year
Gender Identity: *

Male Female
Social Insurance Number:
A SIN is required for all staff
Ontario Health Card #:
Please upload a photo of yourself:
Driver's License Class:
Skype Name:
Do you have any special dietary needs? (i.e. gluten-free, kosher, food allergies, etc.)

No Yes
If yes, please explain:
Do you smoke? *

No Yes
Do you have a current Police/background check? *

No Yes
*All Staff are required to provide a valid Police/background check every 3 years.
What position(s) would you like to be considered for?
First choice: *
Second choice: *
Third choice: *
What dates are you available and interested in working at camp between May 1-Sept 5? *
Education/Occupation and Training
Occupation (includes Student): *

Student
School Attending:
Grade/University Year:
Are you planning to return to school following the summer?

Yes No Undecided
What qualifications do you currently hold?
Check all qualifications that are current:

CPR First Aid Bronze Medallion Bronze Cross Red Cross Instructor Lifesaving Society Instructor NLS Lifesaving Society Examiner
* Must be valid throughout your employment and you must submit a copy of your certification(s) to our office.
Have you used or gone by any other name other than the one you identified on this application? *

No
Do you have a criminal record of have ever been convicted of a crime, or have any charges pending? *

No Yes
If yes, please explain: *
Have you ever been disciplined or sanctioned by a camp body or by an independent body (e.g. sport league, etc) or dismissed from a prior camp or volunteer position? *

No Yes
If yes, please explain: *
Have you ever been subject to a lawsuit (i.e. finding, judgement, ruling, out of court, settlement, etc.) relevant to all forms of assault (physical or psychological), fraud, child pornography, sexual offences, harassment or trafficking of illegal drugs? *

No Yes
If yes, please explain: *
Signature *

Clear
Should be Empty:

2021 STAFF APPLICATION FORM *Returning Staff*

General Information

Education/Occupation and Training

2021 STAFF APPLICATION FORM Returning Staff