2025 Camp Volunteer Application

CAMP AUSOME

Freddie Ford Family Foundation
PO Box 12454, St. Louis, MO 63132

PH: 314-282-5003

FX: 314--282-5003

www.freddiefordfamilyfoundation.org
Job Volunteer Application

Return the completed application to the above address, by fax or email.
Camp Dates: July 21 - July 25 from 8:00 at Miriam High School located at 1138 N. Warson Rd, St. Louis, MO 63132.

Camp Ausome is a summer camp which focuses on helping autistic children reach their full potential and experience a summer free of everyday-life stresses. It's a place where a kid can be a kid, have fun, and learn something new. There will be a maximum of 10 kids enrolled ages 6-11.
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All applicants must specify "Position Applied For": Junior Counselor (Camper Aide) or Camp Counselor Please fill out this application to the best of your ability. Camp Ausome is an equal opportunity employer. We do not discriminate on the basis of race, religion. color. sex. age. national origin. or disability. All applicants will be subject to a criminal background check.

At Camp Ausome we are always looking for enthusiastic, fun-loving. responsible staff with a passion for learning and adventure. Our staff is made up of people with various backgrounds who communicate efficiently, have a good work ethic, demonstrate good problem solving abilities, are creative, fun and energetic, and love to work with children and families. Our hand-picked staff embodies our core principles of (Character, Compassion, Honesty, Respect, Responsibility We need people who have experience working with autistic children and who are open to supporting autistic children in learning new sports and activities.
What position are you applying for?*
What is your preferred t-shirt size?
Please type in your t-shirt size.
Has your name changed?*
If yes, what other names have you used?
AUTISM EXPERIENCE

Experience working with children with autism or any educational background is a bonus, but is not required.
Do you have any experience working with autistic children? If yes, please explain.
Do you have any professional education or certifications relevant to autism?*
Please begin with your current or last job. Include military service assignments. If you include volunteer activities, please exclude organizations that might indicate race, color, religion, national origin, disability or other protected status.
EMPLOYMENT HISTORY
Employer
Name of Employer
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Employer Phone Number
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Employment Date Range
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Supervisor
Reason for leaving
Employer
Name of Employer
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From/To
Employment Date Range
Job Title
Supervisor
Reason for leaving
Phone No.
Employer Phone Number
Job Duties/Responsibilities
Job Title
Supervisor
Supervisor's Name
EDUCATION

Please include the school name, location, diploma or degree received and course of study.
Years completed of school*
Middle or High school
Trade school
College/University
Graduate School
VOLUNTEER EXPERIENCE

Please share any prior volunteer experience you have had interacting with children and adolescents. Include other camps, agencies or organizations such as Big Brother Big Sisters, Sunday School, Scouting, Little league, etc.
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Any specialized training. apprenticeship programs, certifications, or any special job related skills
List any participation in athletics by sport
List any sports that you have coaching experience in
FOREIGN LANGUAGES
Please indicate if you speak, read, write (and whether you are fluent, good or fair) in any language(s) other than English.
PROFESSIONAL, TRADE, BUSINESS OR CIVIC ORGANIZATIONS/OFFICES:
Please exclude organizations that might indicate race, color. religion, national origin, disability, or other protected status.
MILITARY HISTORY:
Current status
Military Branch
PERSONAL:
If less than 18 years of age, can you provide proof of eligibility to work or parent consent?
Have you ever been employed with us before? If so, when?
May we contact your current employer?
Have you ever been convicted of a felony? (Conviction will not automatically disqualify you from employment) If yes, please explain.*
Have you ever been convicted of child abuse or neglect? (Conviction will not automatically disqualify you from employment) If yes, please explain.*
Can you perform the essential job functions of the job for which you are applying?
If applying for a position that requires driving, have you been ticketed for a moving violation in the past 3 years?
If applying for a position that requires driving, do you have the appropriate license?
Are you a citizen of the United States?
If you are not a citizen of the United States, can you provide proof of eligibility to work in this country (for instance a green card, social security card, passport etc)?
AVAILABILITY:
Camp staff hours are 8-1. Can you commit to attending camp every day to ensure stability forthe campers?*
REFERENCES:

Not family members.
Name*
Reference
Address
Phone*
E mail*
example@example.com
Name
Address
Phone
E mail
example@example.com
Name
Address
Phone
E mail
example@example.com
EMERGENCY CONTACT:
Name*
Relationship*
Phone*
Name*
Relationship*
Phone*
Driver's License No.*
Please provide your driver’s license number
Driver's License State*
Please provide the state that issued your driver’s license.
I certify that answers given in this application are true and complete to the best of my knowledge.I authorize investigation into all statements I have made on this application as may be necessary for reaching an employment decision. In the event I am employed, I understand that any false or misleading information I knowingly provided in my application or interview(s) may result in discharge and/or legal action.

I understand also that if employed, I am required to abide by all the rules and regulations of the employer and any special agreements reached by the employer and mc. The applicant understands that neither this document nor any offer of employment from this employer constitutes an employment contract unless a specific document is executed in writing by the employer and employee. Unless a specific document is executed in writing by the employer and employee, all employment here is At-Will. Just as an employee may resign for any reason, the employer may terminate an employee for any reason.
Signature of Applicant

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CERTIFICATE OF APPLICANT AUTHORIZATION FOR RELEASE OF INFORMATION (WAIVER OF RIGHTS TO HAVE POLICE RECORDS CHECKED) (WAIVER OF RIGHTS FOR ALL MEDICAL & PSYCHOLOGICAL EXAMINATION RESULTS)

(Print full name) hereby certify that all statements made on or in connection with this application are true and complete to the best of my knowledge and belief. I understand and agree that any mis-statements or omission of material facts will cause forfeiture on my part to all rights to employment by Camp Ausome.

I hereby authorize all law enforcement agencies, the Veterans Administration, U.S. Army, U.S. Navy. U.S. Air Force, all Military Agencies, all Federal, State, or Local Government Agencies, State and Federal Tax Bureaus, Credit Bureaus, Schools, and Universities, to furnish the holder of this release with any and all available information regarding me in order to determine my suitability for employment.

I authorize the holder of this release to make inquiries of my present and past employers, and co- workers regarding my character, integrity, reputation, and efficiency. I authorize the release of any and all information regarding my employment, credit or any other information, whether personal or otherwise. that may or may not be on their records, and release said company or person from all liability from any damage whatsoever that may ensue from furnishing such information to the holder of this release. Any part of the undersigned application for employment may be released to any local State or Federal Law Enforcement agency.

hereby authorize the Human Resources Department of Camp Ausome to obtain a criminal background check for arrests and convictions to be a part of my application for employment.

I hereby agree to take any medical examination, psychological examination or test to determine the presence of drugs or narcotics which Camp Ausome may require todetermine my qualifications for employment. I do further authorize that the results of said tests be furnished to Camp Ausome and the same shall become a part of my application for employment. Positive testing for the presence of any narcotic substance will result in my disqualification from further consideration for employment.

Photostatic or Xerox copy of this authorization shall be considered as effective as the original.

THIS AUTHORIZATION, YOUR APPLICATION, AND ALL DOCUMENTS SUBMITTED BECOME THE PROPERTY OF THE HUMAN RESOURCES DEPARTMENT OF CAMP AUSOME AND WILL NOT BE RETURNED.
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Signature of Applicant

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For office use only. Please do not complete this form past this line.

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Date received

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Background check: References: Hours of Availability: Days of Availability:
References
Background check
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Interview: Interview completed by:
Interview
Interview completed by
Accepted/not accepted date: Accepted/not accepted initials:
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CAMP AUSOME

Job Volunteer Application

AUTISM EXPERIENCE

EMPLOYMENT HISTORY

EDUCATION

VOLUNTEER EXPERIENCE

FOREIGN LANGUAGES

PROFESSIONAL, TRADE, BUSINESS OR CIVIC ORGANIZATIONS/OFFICES:

MILITARY HISTORY:

PERSONAL:

AVAILABILITY:

REFERENCES:

EMERGENCY CONTACT: