Job Application | Camp Agawak

Personal Information

Full Name *

Email *

Address, City, State, and Zip *

Phone Number *

What is the best day/time and way to reach you? *

Are you available for an interview? *

Yes

Position Applying for

What type of position are you interested in? *

Salary desired *

Dates you are available *

How did you hear about Camp Agawak?

Age and Gender are critical occupational qualifications for the following positions: Cabin Counselor/Activity Instructor, Trip Leader, Activity Specialist, Nurse. If you are applying for one of these positions, please answer the following 2 questions:

Date of Birth *

Month

Day

Year

Gender *

Male

Female

Our staff positions require that you be mobile over a variety of terrain and engage in physical activities with our campers. Do you feel that you are physically able to perform the essential functions of the position you are applying for? *

Yes

If no please explain

Many positions require driving campers. If you have a valid driver’s license, please indicate the state and license number.

State

D.L. #

Camp Agawak is a smoke free, drug free, and alcohol free environment. Are you prepared to abstain from the use of drugs of any kind for the summer on camp premises? *

Yes

Do you have any visible tattoos or body piercings? *

Yes

If yes, please specify

Education

School 1

Start Date

Month

Day

Year

End Date

Month

Day

Year

School

Major

Degree Earned

School 2

Start Date

Month

Day

Year

End Date

Month

Day

Year

School

Major

Degree Earned

School 3

Start Date

Month

Day

Year

End Date

Month

Day

Year

School

Major

Degree Earned

Employment

Position 1

Start Date

Month

Day

Year

End Date

Month

Day

Year

Position Held

Employer

Phone

Supervisor

Reason for Leaving

Position 2

Start Date

Month

Day

Year

End Date

Month

Day

Year

Position Held

Employer

Phone

Supervisor

Reason for Leaving

Position 3

Start Date

Month

Day

Year

End Date

Month

Day

Year

Position Held

Employer

Phone

Supervisor

Camp Experience

Camp 1

Start Date

Month

Day

Year

End Date

Month

Day

Year

Camp Name

Director

Phone

Camper of Staff

Camper

Staff

Camp 2

Start Date

Month

Day

Year

End Date

Month

Day

Year

Camp Name

Director

Phone

Camper of Staff

Camper

Staff

Activities

Please indicate if you can: LEAD (qualified to organize, teach and take charge of the activity independently), ASSIST (general knowledge and experience with the activity), OR leave blank for neither.

Experience

	Lead/Assist	Description
Aerobics	Lead Assist
Archery	Lead Assist
Arts & Crafts	Lead Assist
Backpacking	Lead Assist
Baseball	Lead Assist
Basketball	Lead Assist
Biking	Lead Assist
Canoeing/Kayaking	Lead Assist
Candle Making	Lead Assist
Cooking	Lead Assist
Dance	Lead Assist
Diving	Lead Assist
Drama	Lead Assist
First Aid	Lead Assist
Fishing	Lead Assist
Frisbee Golf	Lead Assist
Gymnastics	Lead Assist
Hiking	Lead Assist
Lifeguard Training	Lead Assist
Overnight Camping	Lead Assist
Photography	Lead Assist
Piano	Lead Assist
Riflery	Lead Assist
Roller Blading	Lead Assist
Running	Lead Assist
Sailing	Lead Assist
Snorkeling	Lead Assist
Soccer	Lead Assist
Softball	Lead Assist
Swimming	Lead Assist
Tennis	Lead Assist
Volleyball	Lead Assist
Water-Skiing	Lead Assist

Please list any specific training, certifications or credentials that may be a benefit to Camp Agawak

Are there any activities that are not listed that you are qualified to Lead/Teach? If so, please describe

Please describe what prior experience or training you’ve had specifically working with children

Please describe your personality

References

Reference 1

Name

City/State

Phone

Relationship

Reference 2

Name

City/State

Phone

Relationship

Reference 3

Name

City/State

Phone

Relationship

Other

Have you ever been arrested or convicted of a criminal offense or at present, the subject of a criminal investigation? *

Yes

If yes, please specify

Have you ever been charged with or convicted of sexual abuse or molestation? *

Yes

If yes, please specify

If hired, are you willing to submit to and pass a random controlled substance test? *

Yes

Do you agree with the statement above? *

Yes

Leave this field blank