Summer Camp Job Application

CampHowse Counselor (Application)

All information is held strictly confidential. This form must be completely filled out. The information is vital to your acceptance and possible placement as a volunteer.
Full Legal Name*

First NameMiddle NameLast Name
Choose one:*

I am a returning Staff or Camp CounselorI have served at CampHowse in other Cities or StatesFirst-time Applicant
Which position are you applying for?*

VolunteerCamp CounselorDirector
Social Security Number*
Your SSN will be used to obtain a criminal background check from a third party.
Photo ID

A photo I.D. (preferably Drivers license, Passport etc.) will be required to be shown at the interview to verify that your photo and name match the name on this application and background check.
Please also upload a current photo of yourself (headshot).

Upload a File

Cancelof
Gender

MaleFemaleOther
Current Age*
Marital Status*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long have you lived in [state]? Years and months*
If you have lived in [state] for less than five years, list your complete addresses for the last five years:
E-mail*

Confirmation Email
Phone Number: Best one to contact you*

Area CodePhone Number
Employment History
Name of Current Employer*
Number of Years At Current Employer*
Previous Employers (Last 3 years)*
Name, Start Date, End Date
Emergency Contact*
Relationship *
Phone (Emergency Contact)*
T-Shirt Size

Adult SmallAdult MediumAdult LargeAdult X-LargeAdult XX-Large
Do you have previous background or training in working with children?

YesNo
If yes, in what way?
MEDICAL CONCERNS

Camp can be physically tiring. The facility or activities may require staff to manage uneven terrain, walking, lifting, stairs, and other strenuous activities depending on the job assignment. Your medical condition (physical fitness, recent or chronic injuries, allergies, physical or emotional limitations, etc.) and even the medications you take may be affected by the activities, the altitude, the foods served, the emotional challenges with the kids, or the sleeping conditions.
Do you have any medical conditions or concerns, or are you taking any medications that you believe could prevent you from being an effective volunteer that we need to know about in order to help you be effective at camp?

NoYes
Please describe:
Education
High School Name*
Do you have diploma or high school equivalency? *
College
College Major
Date of Graduation
Other Education
Personal References*
Reference #1 - Name*

First NameLast Name
Reference #1 - Phone*

Area CodePhone Number
Reference #1 - Email*

Confirmation Email
Reference #2 - Name*

First NameLast Name
Reference #2 - Phone*

Area CodePhone Number
Reference #2 - Email*

Confirmation Email
Personal Profile
List five (5) strengths you have in working with children: Please be specific*
What weaknesses do you have in working with children: Please be specific*

Following Rules: How well do you follow rules and respond to authority

	1	2	3	4	5

1 is Very Well, 5 is Poorly

How do you feel you would be best utilized at camp?
Criminal Background

If your records have been expunged pursuant to applicable law, you are not required to answer yes to the following questions. If you are unsure whether to answer yes, we strongly suggest that you answer yes and fully disclose all incidents to avoid any future issues.
1) Have you ever been convicted of or pleaded guilty to any crimes (including crimes of record which have been expunged and pleas of 'no contest'), including municipal, state and federal?*

NoYes
2) Have you ever been placed on probation, received a Suspended Execution, Suspended Sentence or Suspended Imposition of Sentence for any offense involving a minor child (a child under 18), or been placed on ANY local, state, or federal sexual registry?*

NoYes
3) Have you ever been sued in a civil court of law where the allegations in the suit involved illegal, inappropriate, or sexual conduct or contact with a minor child?*

NoYes
4) Have you ever been subject to any court order involving any sexual, physical or verbal abuse including but not limited to any domestic violence or civil harassment injunction or protective order?*

NoYes
5) Have you ever resigned, been terminated or been asked to resign from a position, whether paid or as a volunteer, due to a complaint(s) of sexual, physical or verbal abuse of minors?*

NoYes
If yes to any above, please explain:*
Print Name*
Signature*
Thank you for your interest in being a part of CampHowse!
Should be Empty:

CampHowse Counselor (Application)

Photo ID

Employment History

MEDICAL CONCERNS

Education

Personal References*

Personal Profile

Criminal Background

Thank you for your interest in being a part of CampHowse!