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Telluride Association Job Application Form
Residential Camp Health Director - Summer 2024
17
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1
Name
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First Name
Last Name
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2
Pronouns (optional)
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3
Email
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example@example.com
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4
Phone Number
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Please enter a valid phone number.
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5
Please select your certification (must be valid in New York State).
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Physician
Physician Assistant
Nurse Practitioner
Registered Nurse
Licensed Practical Nurse
Emergency Medical Technician
None of the above
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6
During the prep period (June 3-June 21, 2024), are you available to work 20 hrs/wk? During this time, remote/hybrid work is an option, and travel to training may be required.
*
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YES
NO
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7
During the program period (June 23 - Aug 8, 2024), are you available to work full time and live on site at 217 West Ave, Ithaca, NY 14850?
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YES
NO
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8
Please share any other pertinent information about your availability.
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9
Have you ever worked for Telluride Association before?
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YES
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10
How did you hear about us?
*
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Indeed.com
Telluride website
Social media
Referral
Other
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11
If you were referred by someone, please provide their name.
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12
Upload Resume
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13
Upload Cover Letter
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14
Please provide any additional information about your experience.
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15
Please provide three references who are not related to you.
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16
Have you ever been fired or asked to resign from a job? If so, for what reason?
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17
Certification & Signature
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I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Telluride Association to hire me. If I am hired, I understand that either Telluride Association or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Telluride Association, except the Executive Director and President of the Board of Directors, has the authority to make any assurance to the contrary. I attest with my signature below that I have given to Telluride Association true and complete information on this application. No requested information has been concealed. I authorize Telluride Association to contact references provided for employment and reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.
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