Camp Homeward Bound
Camp Staff Application
Personal Information
Date of Application
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Month
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Day
Year
Date
Name
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First Name
Last Name
Permanent Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
At current address until
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Month
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Day
Year
Date
Phone Number
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Area Code
Phone Number
Email
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example@example.com
Camp Placement Information
Start date available
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Month
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Day
Year
Date
End date available
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Month
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Day
Year
Date
Position applying for
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Other positions you are qualified for
Age & Eligibility
Will you be at least 18 years old by first day of employment?
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Yes
No
Will you be at least 21 years old by first day of employment?
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Yes
No
Are you eligible for employment in the United States? If no, you will be given information about how to apply as an international applicant.
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Yes
No
Do you have any physical limitations that might prevent you from performing the full responsibilities of the position applied for in a safe and efficient manner?
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Yes
No
If yes, please explain:
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Where did you hear about Camp Homeward Bound?
Where did you hear about Camp Homeward Bound?
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I met a Camp Homeward Bound or Coalition for the Homeless representative
A present or former Camp Homeward Bound or Coalition for the Homeless staff member
College Career Office
In the Media
American Camp Association
Internet
Summer Employment Directory
Other
What is the name of the present or former Camp Homeward Bound or Coalition for the Homeless staff person?
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Which college/website/directory/publication?
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Education
Current College Status
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Freshman
Sophomore
Junior
Senior
Graduate
No College
Educational Background
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Rows
School Name
Location
Concentration/Major/Minor
High School
College
Graduate Work
Experience
Please list past and current jobs/volunteer work activities including military service, employment while in school, and self employment. Please begin with the most recent.
Start Date (1)
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Month
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Day
Year
Date
End Date (1)
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Month
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Day
Year
Date
Company/Organization (1)
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Address (1)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Responsibilities (1)
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Start Date (2)
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Month
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Day
Year
Date
End Date (2)
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Month
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Day
Year
Date
Company/Organization (2)
Address (2)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Responsibilities (2)
Start Date (3)
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Month
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Day
Year
Date
End Date (3)
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Month
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Day
Year
Date
Company/Organization (3)
Address (3)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Responsibilities (3)
References
Use this section to give us an idea of who you will be using as references. Former and present employers, supervisors, and school advisors are preferred. Please remember that relatives should not be listed as references. Most importantly, you should include people who have seen you working with children when possible. Please provide three (3) references.
Name (1)
*
Company/Organization/School (1)
*
Phone Number (1)
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Area Code
Phone Number
Email (1)
*
example@example.com
Capacity known (e.g. employer, school advisor, etc.) (1)
*
Name (2)
Company/Organization/School (2)
Phone Number (2)
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Area Code
Phone Number
Email (2)
example@example.com
Capacity known (e.g. employer, school advisor, etc.) (2)
Name (3)
Company/Organization/School (3)
Phone Number (3)
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Area Code
Phone Number
Email (3)
example@example.com
Capacity known (e.g. employer, school advisor, etc.) (3)
Certifications
Please tell us about any certification courses that you have taken - courses such as First Aid, CPR, Responding to Emergencies, Lifeguarding, Water Safety Instruction, etc. are very useful at camp.
Do you have a current Driver's License?
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Yes
No
If yes, expiration date:
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Month
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Day
Year
Date
Name of Certification (1)
Date of Course (1)
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Month
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Day
Year
Date
Expiration Date (1)
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Month
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Day
Year
Date
Name of Certification (2)
Date of Course (2)
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Month
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Day
Year
Date
Expiration Date (2)
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Month
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Day
Year
Date
Name of Certification (3)
Date of Course (3)
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Month
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Day
Year
Date
Expiration Date (3)
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Month
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Day
Year
Date
Name of Certification (4)
Date of Course (4)
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Month
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Day
Year
Date
Expiration Date (4)
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Month
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Day
Year
Date
Essay Questions
Please describe any leadership experiences you have had.
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What summer camp experiences, if any, have you had?
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Please describe any other experiences you have had working with children.
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Acknowledgment
I certify that the information given above is true and complete, and I understand that misrepresentation and/or withholding of information will result in the rejection of this application or my discharge if discovered after employment begins. I authorize the Coalition for the Homeless (CFTH) to make inquiries regarding my history and release CFTH from all liability with respect to such inquiries. I understand that if employed by CFTH that I will be an employee "at will" and that I may terminate my employment at any time, with or without cause or note, and that CFTH also has that right. If I am employed, I agree to abide by CFTH's policies, rules, and procedures, and any changes thereto.
Signature
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Date
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Month
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Day
Year
Date
Submit
Submit
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