Camp Fire Wilani Application
Contact Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Are you at least:
*
18 years old
21 years old
25 years old
Other
Position I am Applying For:
Spring Outdoor School Field Instructor (18+, March 25 - June 6)
Summer Camp Staff (18+ June 17th - July 16th )
Employment History
Job Title 1
*
Place of Employment - Name
*
Start Date
*
-
Month
-
Day
Year
Date
End Date
*
-
Month
-
Day
Year
Date
Place of Employment - Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor Name
*
First Name
Last Name
Supervisor Phone
*
Please enter a valid phone number.
Reason for Leaving
*
Job Title 2
*
Place of Employment - Name
*
Start Date
*
-
Month
-
Day
Year
Date
End Date
*
-
Month
-
Day
Year
Date
Place of Employment - Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor Name
*
First Name
Last Name
Supervisor Phone
*
Please enter a valid phone number.
Reason for Leaving
*
Job Title 3
*
Place of Employment - Name
*
Start Date
*
-
Month
-
Day
Year
Date
End Date
*
-
Month
-
Day
Year
Date
Place of Employment - Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor Name
*
First Name
Last Name
Supervisor Phone
*
Please enter a valid phone number.
Reason for Leaving
*
References
Reference 1 Name
*
First Name
Last Name
Reference 1 Place of Employment
*
Reference 1 Job Title
*
Years Known
*
Relationship to You
*
Direct Supervisor
Instructor
Coach
Other
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Reference 2 Name
*
First Name
Last Name
Reference 2 Place of Employment
*
Reference 2 Job Title
*
Years Known
*
Relationship to You
*
Direct Supervisor
Instructor
Coach
Other
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Reference 3 Name
*
First Name
Last Name
Reference 3 Place of Employment
*
Reference 3 Job Title
*
Years Known
*
Relationship to You
*
Direct Supervisor
Instructor
Coach
Other
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Understandings
Initial each understanding
1.) I understand that Camp Fire Wilani is a drug, tobacco, and alcohol-free workplace.
*
Initals
2.) I understand that I will need to submit to and successfully complete an FBI enhanced criminal background check.
*
Initals
Have you ever been convicted of a crime, including child abuse?
Yes
No
I attest that the information provided by me in this application is true and accurate to the best of my knowledge.
*
Submit
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