Part-time and Volunteer Application

Part-time and Volunteer Application

Kitchen, Snack Shop, Facilities, Lifeguard, Volunteer
Position(s) applying for (see above)*
Location (Dallas, Scranton, Hazleton)*
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
T-Shirt size*

SMLXLXXLOther
Which, if any, of the following clearances do you hold?

PA Child Abuse HistoryPA Criminal BackgroundFBI Fingerprints
Have you ever been convicted of a crime? If yes, please explain. *
Do you have children? If so, would they need to be at camp with you?
References

Please list 2 professional people who are familiar with your character and qualifications.
References
First Name   Last Name
Email
Area Code   Phone Number
First Name   Last Name
Email
Area Code   Phone Number
Current or Last Employment
Company Name
Supervisor

First NameLast Name
Your responsibilities
Reason for leaving
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Phone Number
Please enter a valid phone number.
Education
School Name

School NameCurrent Grade/Level
Degree(s) attained
Medical
Do you have accident and hospital insurance?*

YesNo
Company and Policy Number*
Explain any serious illnesses or injuries from the past 5 years:
Please list any physical, mental, or emotional limitations:
Please list any allergies to food or medications:
In an emergency contact:
First Name Last Name Area Code Phone Number
Additional Questions
Have you been a camper or volunteer at Camp Orchard Hill or another camp? Give details.*
Please state your experience of salvation and commitment to Jesus Christ, if applicable to your life.*
What experiences, skills, certifications, and/or qualifications do you possess that would be useful in a camp setting? *
Why do you want to work at Camp Orchard Hill? *
Do you work well with children and teenagers? Explain why. *
What would you most want children to gain from being with you? *
Disclaimer and Signature

I hereby certify that all of the information that I have provided to Camp Orchard Hill in this application or otherwise is true. I give permission to Camp Orchard Hill and its agents to attempt to verify the information that I have provided by questioning my references, employers, schools, friends, family members and anyone else who is contacted by Camp Orchard Hill to release allinformation that they possess about me to Camp Orchard Hill or its agents. I understand that if, in the sole opinion of Camp Orchard Hill I have provided false, misleading or incomplete information, my application will be rejected or if it has already been accepted, I will be terminated.
Signature*

Clear
Parent/guardian signature, if applicant is under 18

Clear
Today's Date*

MonthDayYear
Date
Should be Empty:

Part-time and Volunteer Application

References

Current or Last Employment

Education

Medical

Additional Questions

Disclaimer and Signature