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SERTOMA
CAMP ENDEAVOR
Camp Endeavor 2023
June 25th - July 1st
Paid Staff Application
*
First Name
*
Last Name
*
Email Address
*
Date of Birth
*
SS#
*
Consent to background check?
Yes
No
*
Age
Gender
Male
Address
City
State
Country
Postal Code
VP Number
Phone Number
Can we text this number?
Yes
T-Shirt Size
Adult Small
Position(s) applying for:
Cabin Counselor
Outdoor/Sports Instructor
Discovery Instructor
Art Instructor
Chef
Kitchen Crew
Lifeguard
ASL/DEAF Culture Instructor
If other, please explain:
(1)Current/Most Recent Employer
(1)Current/Most Recent Employer Phone #
(1)Position
(1)Job Duties/Responsibilites
(1)Reason For Leaving
(2)Past Employer
(2)Past Employer Phone #
(2)Position
(2)Job Duties/Responsibilities
(2)Reason For Leaving
*
Educational History: School/College Name
*
Degree/Diploma
Educational History: School/College Name
Degree/Diploma
Other Educational Information?
Skills
Discovery Initiatives
Orienteering
Tent Camping
Campfire Cooking
Swimming
Canoeing
Kayaking
Dance
Skits
Tumbling
Martial Arts
Tie-Dye
Painting
Sketching
Macrame
Nature Crafts
Archery
Fishing
Volleyball
Softball
Flag Football
ASL Storytelling
Videography
iMovie
Photography
Other skills?
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1st Reference Name
*
1st Reference Phone #
*
Relationship to 1st Reference
*
2nd Reference Name
*
2nd Reference Phone #
*
Relationship to 2nd Reference
*
3rd Reference Name
*
3rd Reference Phone #
*
Relationship to 3rd Reference
Sign Language Fluency
Beginner
*
Please Explain
Have you taken sign language/Deaf related courses?
Yes
Do you have a valid Driver's License?
Yes
Do you have CPR certification?
Yes
Do you have First Aid certification?
Yes
Do you have a Lifeguard certification?
Yes
Do you have a Sign Language Interpreting certification or credential?
Yes
*
Do you have any other certifications or qualifications?
*
Please list prescribed medications: (indicate if none)
*
Emergency Contact
*
Emergency Contact Phone #
Are you covered by health insurance?
Yes
If yes, indicate carrier or plan name
Policy Number
Name of Insured/Relationship to Applicant
Any existing medical conditions?
Any environmental or food allergies?
*
Why do you want to work at Camp Endeavor?
*
Why are you a good fit for this job at Camp Endeavor?
Any additional comments:
SUBMIT
2023 Paid Staff Application
Friday, June 23rd -Sunday, July 2nd
Sertoma Camp Endeavor
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