Staff Application

STAFF APPLICATION

FOUNDATION FOR DREAMS & DREAM OAKS CAMP
Name

First NameLast Name
Middle Initial
Cell Phone
Please enter a valid phone number.
Home Phone
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Age
Date of Birth

MonthDayYear
Date
Sex
Parent/Emergency Contact

First NameLast Name
Parent/Emergency Contact Phone Number
Please include area code.
Staff Position Desired
Available Dates
Talents/Strengths
T-Shirt Size (Unisex)
How did you hear of us?

Educational History
Name of High School
Location
Grade completed
Name of College/University
Location
Level Completed
Degree:

NoYes
Major
Credentials and Certifications
Courses, Jobs or Experience related to children with special needs and/or at-risk youth:

References
Three letters of reference are required for full-time employees/volunteers. Two must be of a professional or educational nature, and one may be personal (no relatives). Please attach references below.
Reference Letter 1

Cancelof
Reference Letter 2

Cancelof
Reference Letter 3

Cancelof
Accident/Medical Insurance
Name of Company
Group Number
Additional information: (In answering, include offenses or charges to which a guilty or nolo contendere plea was entered or, if convicted, a sentence of probation was imposed.)
Have you ever committed, been convicted of, a violation of the law or forfeited collateral, other than a non-moving traffic violation, such as a parking ticket?

YESNO
Are you now under charges for any offense against the law?

YESNo
If you answer "YES" to any of the above questions, please explain

FOUNDATION FOR DREAMS, INC. STATEMENT OF POLICY
Foundation for Dreams, Inc. is an Equal Opportunity/Affirmative Action employer. As such Foundation for Dreams, Inc. pledges to take the necessary action to preclude discrimination in recruiting, employment, training, disciplining, and/or terminating of employees because of race, color, creed, age, sex, national origin, handicap status, veteran status or other reason in accordance with all applicable state and federal statutes, executive orders and regulations which prohibit discriminatory personnel practices.
CERTIFICATION OF APPLICANT
I certify that the information given on this application and in any other supporting documentation, resume, etc., is true and correct. I understand that any false information; willful or negligent misrepresentation; or failure to disclose any requested information will constitute sufficient grounds for Foundation for Dreams, Inc. to terminate my employment without notice. I further understand that Foundation for Dreams, Inc. may perform a pre-employment investigation to determine my suitability for employment and I authorize Foundation for Dreams, Inc. to secure the infomration necessary to make the decision. I hereby release from liability any and all individuals and organizations that provide information to Foundation for Dreams, Inc. concerning my professional competence, ethics, character and other qualifications and authorize my prior employers to release any requested information from my personnel files. I further understand that Foundation for Dreams, Inc. will adhere to applicable state and federal statutes concerning the securing of information, handling, utilization and release of information obtained in thepre-employmentinvestigation. l acknowledge by my signature that I have read and understand these statements.
Signature

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Date

MonthDayYear
Date
Parent/Guardian Authorization for CIT volunteers under the age of 18:
I/we hereby give permission for applicant's name to be employed and/or volunteer for the Foundation for Dreams, Inc. and Dream Oaks Camp.
SIGNATURE OF PARENT/GUARDIAN

Clear
Date

MonthDayYear
Date
PRINTED NAME OF PARENT/GUARDIAN
Should be Empty:

STAFF APPLICATION

Educational History

References

Accident/Medical Insurance

FOUNDATION FOR DREAMS, INC. STATEMENT OF POLICY

CERTIFICATION OF APPLICANT