2022 Staff Application Form (Returning)

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 2022): *

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:

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 duration of employment are you interested in?

*

Other:

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 Lifesaving Society Swim Instructor (LSSI) Lifesaving Society Instructor (LSI) National Lifeguard (NL) 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

2022 STAFF APPLICATION FORM *Returning Staff*

General Information

Education/Occupation and Training

2022 STAFF APPLICATION FORM Returning Staff