Camp Wightman Summer Staff Application Form

Application for Camp Wightman Summer Staff
Camp Wightman is a residential Christian summer camp located on a beautiful lake on 275 acres of land. The summer staff lives on the property and has the opportunity to develop skills, meet new friends and support the campers. This is a seasonal position. Room and Board are included. Please complete the application below or contact Holly Blacker at 860-376-2179.
Personal Information:
Full Name *

First Name Middle Initial Last Name
School Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Permanent Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail *
Are you legally permitted to work in the United States? *

Yes No
Will you be at least 18 years of age by June 1?
If not, what will your age be as of June 1?
Can you perform the essential functions of the job(s) for which you are applying, with or without reasonable accommodation?
Further information you wish to provide regarding age or essential functions:
Summer dates available? Example: May 15 until August 27
Employment Desired:
Position Applying For *
Education:
High School *
Name of High School Attended
Graduated? *

Yes No
College *
Name of College/University Attended
Number of Years Attended
Area of Study/Degree *
Graduated? *

Yes No
Skills/Qualifications:
Skills
List any relevant skills
Certifications: Please list with name of certifying body and expiration dates.
List any relevant certifications or qualifications
Work or Volunteer History:
Previous Employer
Name of Previous Employer
Position
Reason for Leaving?
Start Date

Month Day Year
End Date

Month Day Year
Previous Employer
Name of Previous Employer
Position
Reason for Leaving?
Start Date

Month Day Year
End Date

Month Day Year
Harassment – Camp Wightman prohibits all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment. Have you ever been accused of harassment of any person including, but not limited to, workplace harassment? (Note – a prior accusation or conviction is not an automatic bar to employment. The type of accusation or conviction and when it occurred will be evaluated before any decision is made.)
*

Yes No
Criminal Record – Have you ever been convicted of a crime, other than a minor traffic offense? If yes, please describe. (Note – a prior conviction is not an automatic bar to employment. The type of conviction and when it occurred will be evaluated before any decision is made.)
*

Yes No
Who will you be asking to be your references?
You must have two references. Your references should be people who know your work ethic, as well as your ability and expertise to work with children and teens. Non-relatives preferred.
Reference 1 *
Name of Reference
Relationship
Years Acquainted
Phone *
Email *
Reference 2 *
Name of Reference
Relationship
Years Acquainted
Phone *
Email *
This section is for Summer Camp Counselor candidates. We offer many activities. We have only provided a sampling here. Please provide information about your interests and abilities. Thank you.
Please check any program activities you are able to assist in teaching:

Creative Arts: Watercolors, Drawing, Crafts Sports & Games: Soccer, Volleyball, Basketball, Fitness Performance Arts: Dramatics, Music, Drumming Waterfront: Swimming, Canoeing, Kayaking, Sailing, Paddle Boarding, Snorkeling Healthy Living: Fitness, Manners, Cooking Outdoor Adventure: Archery, Fishing, Hiking, Nature Exploration, Cooking
Please check any program activities you are able to lead and teach:

Creative Arts: Watercolors, Drawing, Crafts Sports & Games: Soccer, Volleyball, Basketball Performance Arts: Dramatics, Music, Drumming Waterfront: Swimming, Canoeing, Kayaking, Sailing, Paddle Boarding, Snorkeling Outdoor Adventure: Archery, Fishing, Hiking, Nature Exploration, Cooking
1) Describe any experiences and/or training you have in working with children.
2) Describe any unique or special skills you have that would be beneficial in a camp setting.
3) Describe your experience in leading worship, leading devotions, and sharing your faith with others in a group setting.
Complete submission of application:
By clicking the submit button below, I certify that to the best of my knowledge, the information provided in this application is correct. I authorize investigation of all statements herein, and grant permission for individuals or organizations listed on this application to provide any information they may have with regard to my ability and fitness to work with children or youth. I release Camp Wightman and those individuals or organizations from any liability associated with conducting that investigation. I understand that untrue, misleading, or omitted information may result in dismissal, regardless of the time of discovery by Camp Wightman.
Signature *

Clear
Date *

Month Day Year
Should be Empty:

Application for Camp Wightman Summer Staff

Personal Information:

Employment Desired:

Education:

Skills/Qualifications:

Work or Volunteer History:

Who will you be asking to be your references?

Complete submission of application: