2025 Application for Camp Leadership Programs

2025 Application for Camp Leadership Programs
Conditions of acceptance are stated at the end of this form. Please read them carefully before you sign this application.

Girl Scouts of Connecticut does not discriminate in its programs or hiring on the basis of race, color, religion, age, sex, sexual orientation, marital or civil union status, national origin or ancestry, political affiliation, socio-economic factors, genetic information, learning disability, physical or mental disability, military status, or any other protected class status.
Do you love working with younger kids? Put your passion into action as we explore the basics of leadership skills needed to work with younger campers, practice planning for activities, and find out what it takes to help out at camp with younger campers. Participants in this program will spend part of each day in leadership training, part of the day working with younger campers and part of each day participating in your favorite camp activities.

You do not have to turn in your references with your application, you can turn them in during your interview with the camp director or designee.
Date of Application*

MonthDayYear
Date
Session Start Date*

MonthDayYear
Date
Leadership Program*

Program Aide (6th -9th grade)Counselor in Training 1 (10th grade & up) - Laurel and Clatter Valley onlyCounselor in Training 2 (11th grade & up) - Laurel and Clatter Valley onlyCounselor in Training 3 (12th grade) - Laurel and Clatter Valley only
Camp*

AnSeOxAspetuckMerrie-WoodClatter ValleyLaurel (Sleep Away)
Applicant's Personal Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Best Time to Call*
Email*
example@example.com
Education
School Name*
Town, State*
Grade in Fall of 2024*
School Activities*
Girl Scouting, Clubs, and Other Youth Organizations*
Summer Camp Experience
Have you worked at or attended summer camp before?*

YesNo
Camp Name*
Year(s) at Camp*
Camp Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Activities, Responsibilities, Certifications Earned*
Sponsoring Organization - Please Select One*

Girl ScoutsYMCA4-HChurchOther
If "Other" please explain:*
Camp Name
Year(s) at Camp
Camp Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Activities, Responsibilities, Certifications Earned
Sponsoring Organization - Please Select One

Girl ScoutsYMCA4-HChurchOther
If "Other" please explain:
Additional Questions
Why do you want to participate in this leadership opportunity?*
What skills would you like to gain during the program?*
List five words that describe you.*
Certification
I certify that my answers to the preceding questions are true and complete and that I have not knowingly withheld any information which might, if disclosed, affect my application unfavorably. I understand that any misrepresentation or omission of facts on this application will be cause for rejection of this application. I also understand that I must submit two letters of reference from a non-family member and go through an interview process.
Signature*

Clear
Date*

MonthDayYear
Date
I certify that I am aware that my child is applying for a leadership program at camp. I understand that it is a selection process and I support my child’s endeavors in this process. I also understand that I am responsible for completing the camp registration form online and appropriate camp fees if they are selected for this program. I understand that financial aid is available.
Signature*

Clear
Date*

MonthDayYear
Date

2025 Application for Camp Leadership Programs

Applicant's Personal Information

Education

Summer Camp Experience

Additional Questions

Certification