Camp Staff Application for Employment

Personal Contact Information

Camp: Elk Lick
First Name:
Middle Initial:
Last Name:
Work Phone:
Home Phone:
E-mail:

Permanent Address
Street Address:
Address (cont.):
City:
State:
Zip Code:

Temporary Address (if applicable)
Street Address:
Address (cont.):
City:
State:
Zip Code:
 
Are you 21 or over?
If not, how old?

 

Scouting Experience

No scouting experience is required for a job,
only a desire to have fun and work with kids!
Scout Troop:
Current Rank:
What leadership positions have you held?
Previous experience at camps:
Previous positions at camps:

 

In the box below, explain why you want to work on camp staff.  Feel free to include any other information that you would like us to know.

 

What positions would you like to hold at Camp Merz?
(Number your top 3 job preferences in order, using "1" as your top choice.)
Program Director Ecology Director Aquatics Specialist
Business Manager Scoutcraft Director Scoutcraft Specialist
Aquatics Director 1st Year Camper Director Ecology Specialist
Shooting Sports Dir. Archery Instructor Eagle Trail Specialist
Climbing Director (ELSR Only) Climbing Instructor (ELSR Only) Technology Specialist
Health Officer (EMT, LPN, RN) Commissary Manager Counselor in Training
Eagle Trail Director Trading Post Manager

Other

Commissioner 1st Year Camper Specialist
   

 

Have you participated in any of the following activities or hold any of these certifications?
Check if Yes Type of Certificate Expiration Date
BSA National Camp School
Red Cross W.S.I./Lifeguard
Lifeguard B.S.A.
NRA Instructor
E.M.T./Nurse/MD
Red Cross First Aid
C.P.R.
Woodbadge/Other Scout Training
Other:

 

Which have you earned, or , feel qualified to instruct?

Archery Geology Shotgun
Astronomy * Hiking Small Boat Sailing
Backpacking Indian Lore Soil & Water Conservation
Basketry Insect Study * Swimming
Bird Study Leather Work Weather
* Camping * Lifesaving Wilderness Survival
Canoeing Mammals Study Wood Carving
Climbing Metal Work  
C.O.P.E. Nature Tenderfoot
Cooking Orienteering 2nd Class
* Emergency Preparedness * Personal Fitness 1st Class
* Environmental Science Pioneering Totin' Chip
* First Aid Reptile & Amphibian Study Firem'n chit
Fish & Wildlife Management Rifle Paul Bunyan Woodsman
Fishing Rowing Mile Swim BSA
Forestry   Snorkeling BSA

   

Other Questions
Highest educational institution attended:
Diplomas, certificates, or degrees:
Have you ever been convicted of a crime:
If "Yes", explain:
Do you used illegal drugs?
If "Yes", explain:
List activities or hobbies:
List awards, societies, honors, etc.:
(include OA honor)
Dates Available:
Salary Expected:  $

 

References

Please list three adult references (other than relatives) whom we may contact regarding your application.  Examples:  Teachers, Principal, Minister, Former employer, etc.
Name Address and Phone Number Relationship

 

Signatures

All the statements on this application are true to the best of my knowledge and I meet the age requirements of the jobs applied for.  I understand that a personal interview may be required prior to my being offered a position on Camp Merz Staff.

Entering my full name in the space below will constitute a digital signature on this application for the purpose of being considered for a position on Camp Merz Staff.  I recognize that if I am under the age of 18, I must have my parents actual written signature before being offered a position on Camp Merz Staff.
Applicants Full Name:

 

 Date:
Parents full name:
(if under 18) 		Date:

 

 

Please complete the information in the application to the best of your ability. This information will be kept strictly confidential.