2023 Camp Staff Application Form

List three positions you are interested in. *

Working availability beginning on: *

Month Day Year
June 2023
Through what end date: *

Month Day Year
August 2023
I am available the entire summer season *
Mid June-Mid August
If you are not available the entire season, please list dates you will miss.
Philmont, Sea Base, Jamboree, vacation, etc.
What is your best e-mail address? *
example@example.com
If you are under 18, please also provide a parent/guardian email and phone number.
Parent/Guardian Email
example@example.com
Parent/Guardian Phone
Please enter a valid phone number.
How often do you check your email? *

Daily Weekly
What is your permanent phone number? *
Current Address is Valid Until: *

Month Day Year
Date
What is your permanent address? *

Street Address

Street Address Line 2

City State / Province / Region

Postal / Zip Code Country
What is your current address? *

Street Address

Street Address Line 2

City State / Province / Region

Postal / Zip Code Country
Present Occupation or Year in School: *

Areas of Interest & Personal Statement:
Briefly describe why you think you are qualified for the position(s) you are applying. *
List any of your certifications that will be current through August 2022: *
OTHER RELATED TRAINING OR SKILLS (please indicate expiration date mm/dd/yyyy) *
Working at a summer camp is difficult at times. Your duties will include working long hours, putting camper’s needs first, and cleaning parts of camp. How do feel about these things and why would you be good working in this kind of an environment? *

References:
REFERENCES: List three (3) persons NOT related to you who can judge your qualifications for this position. If you have previous experience as a camp staff member, one reference should be from a camp director or camp administrator.
Reference Name: *
Reference Phone Number: *
Reference E-mail: *
example@example.com
Reference Position Title: *
How long have you known this reference? *
What is your relationship with this person? *
Reference Name *
Reference Phone Number: *
Reference E-mail: *
example@example.com
Reference Position Title: *
How long have you known this reference? *
What is your relationship with this person? *
Reference Name *
Reference Phone Number: *
Reference E-mail: *
example@example.com
Reference Position Title: *
How long have you known this reference? *
What is your relationship with this person? *

Submission:
I understand that a successful completion of a physical examination and current immunizations are conditions of employment. *

Yes No
I understand that employment is contingent upon passing a criminal background check and drug test and I give Chester County Council, BSA permission to conduct a check if necessary. *

Yes No
I certify that all information provided is true and complete. I understand that falsification or significant omission of any information may be considered justifications for dismissal if discovered at a later date. *

Yes No
Signature

Use the mouse to draw your signature. Clear
Date *

Month Day Year
Date
Chester County Council, Boy Scouts of America is an Equal Opportunity Employer. The Council does not discriminate on the basis of race, color, sex, age, disability, pregnance, national origin, citizenship or sexual orientation.
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Camp Staff Application