2012 Staff Application

In accordance with the Children's Online Privacy Protection Act a person must be 13 years of age or older to complete and submit this form.

Please Note:  All prospective staff members must be 18 years or older in order to be considered for a position.  The completion of at least one year of college or other year of post-high-school experience is strongly preferred.  Incomplete or overly brief applications will not be considered.

Only U.S. and Canadian citizens should complete this application.
Citizens of other countries please click here.

Please fill out & complete all fields.
Which Campus Kids Camp are you applying to?
 New Jersey Camp
      Tom Riddleberger, Director
      800-633-7350		 Minisink, New York Camp
      Jani Brokaw, Director
      888-621-2267		 No Preference
Full Name
 		Email
 		Phone Number
Present Mailing Address
 City
    State
  		Zip Code

Until what date can we send mail to your present address?  
Permanent Mailing Address
 City
    State
  		Zip Code
Current occupation and/or school now attending:    
Are you 18 or older? Yes  No        Do you have the legal right to work in the United States?  Yes  No
Are you available for work from June 17 to August 18, 2012?   Yes  No
 Position you are applying for?   (Check all that apply)
 Counselor (counselors are both bunk counselors and activity specialists)
Head Counselor / Village Director Program Director Camp Nurse
Director of an
activity area:		 Aquatics Fine Arts Performing Arts
Athletics Camping/Nature Adventure Program
Office Staff
(manager or assistant)		 Driver Support Staff
(food service/maintenance/housekeeping)
Age of children you prefer to work with?  7-8    9-10    11-12    13-15    No Preference
Education (complete all that apply):
Use these boxes to tell us:
Name of school,
major studies,
dates of attendance,
degree earned,
honors & distinctions		 High School
 College
Graduate
 Special

Experience as a CAMPER when you were a child:
Use these boxes to tell us:
Name & location,
dates of attendance,
type of programs,
director's name.		 Camp 1
 Camp 2
 Camp 3

Camp Employment Experience:
Use these boxes to tell us:
Name & location,
dates of employment
duties, salary,
director's name,
phone number.		 Camp Employment 1
 Camp Employment 2
 Camp Employment 3

OTHER Employment Experience:
Use these boxes to tell us:
Name & location,
dates of employment
duties, salary,
supervisor's name,
phone number.		 Other Employment 1
 Other Employment 2
 Other Employment 3

Volunteer Experience:
Use these boxes to tell us:
Name & location,
dates volunteered
duties,
supervisor's name,
phone number.		 Volunteer Experience 1
 Volunteer Experience 2
 Volunteer Experience 3

Questions
Briefly describe the most significant experiences you have had working with children.


In relation to the job you are applying for, what are your strengths?
Tell us about your most positive personal attributes, skills and abilities.


In relation to the job you are applying for, what personal attributes, skills and abilities
would you most like to improve?  These could be areas you don't feel as confident in or
things you know you want to learn/improve.  Adults who are good role models for kids
are not afraid to show that they are still learning and growing.


Why do you want to work for Campus Kids?


How did you first hear about Campus Kids?


Do you know someone who has worked at Campus Kids or is applying to work for
Campus Kids? Yes     No.  If yes, please indicate who and how you know this person.


Describe any special talents/experiences you have working with persons who have disabitlities or special needs?


What languages do you speak?


What academic subjects can you tutor?


Are there any reasons you may have difficulty performing any of the essential functions of the job for
which you have applied?  Yes   No.  If yes, please explain.


Have you ever been convicted of a crime?  Yes   No.  If yes, please explain.


Have you ever been convicted of child abuse or sexual assault?  Yes   No.  If yes, please expain.
 Certifications & Course Completions 
Describe in detail those you currently hold & expiration dates
Campus Kids will request proof of certification before confirming a job offer.
First Aid:
 CPR: 
Lifeguard: 
 Swim Instructor: 
Boating Instruction: 
 Other Aquatic: 
Archery: 
 Gymnastics: 
Adventure/Challenge Course: 
 Other: 
R.N.: 
 E.M.T. 
L.P.N.
 Teaching License (State & Level): 
Will you be willing to drive a 12 passenger van or mini-van for camp activities (must be at least 21)?  Yes    No 

Would you be willing to (and feel you have the ability to) take a course to earn certifications in the following areas:
 [Check all that apply]: Lifeguarding Swim Instructor
Ropes Course   Gymnastics Instructor  Small Craft Instructor
 First Aid/CPR Archery Instructor  

Intersests & Abilities -- Read the following rating sysem carefully!
Place the appropriate number in front of EACH activity
  4- I am a qualified expert with teaching experience and I could head this program.  
  3-  I am excellent in this activity but with no teaching experience.  I might be able to head this program.  
  2- I feel qualified to be an assistant instructor of this activity.   
  1- I have done this activity, but am not qualified to teach it.   
  0- I have never done this activity.  
  Sports & Fitness   Areobics  Archery   Baseball
  Basketball   Cricket   Fencing   Field Hockey
  Football   Golf   Gymnastics   In-Line Skating
  Yoga   Jogging   Lacrosse   Matrial Arts
  Skateboarding   Soccer  Softball   Squash
  Tennis   Ultimate   Volleyball   Weight Training
   
       
  Fine Arts   Arts & Crafts   Basketry   Candle Making
  Ceramics   Digital Photography and Editing   Drawing
  Jewelry   Macrame   Nature Crafts   Origami
  Painting   Paper Mache   Sculpture   Tie Dyeing
  Weaving   Woodworking
       
  Performing Arts   Acting  Directing   Script Writing
  Magic   Puppetry   Costuming   Stage Lighting
  Make-Up   Set Design   Stage Sound   Choreography
  Modern Dance   Jazz Dance   Ballet Dance   Folk Dancing
  Singing   Video   Guitar   Drums
  Piano  (check skills):     Popular     Classical     Ear     Sight
Other Instruments:
  Outdoor Life   Camping (tents)   Fire Building   Nature
  Outdoor Cooking   Orienteering   Fishing   Environmental Study
  Mountain Biking   Gardening   Rock/Wall Climbing   Belaying Experience
  Adventure/Challenge Course
       
   Aquatics   Canoeing  Kayaking   Sailing
  Swimming
   Misc Camp Activities   Camp Newspaper   EveningPrograms   Chess
  Cooperative Games & Team Building   Juggling   Rocketry
  Radio Station   Story Telling   Creative Writing    Cooking
  All Camp Theme Days & Special Events   Campfires  
 
       
 
       
References
References are required for consideration of this application.  We need three.  A link to our refence form will appear on the confirmation page upon completion of this application.  Print out the reference form or send the link to your reference via email.  Your references should be former or present employers, teachers, supervisors.  Our preference is from persons who have seen you work with children.  They should NOT be relatives or neighbors.   All references will be verified by Campus Kids.
Reference Name Mailing Address Phone Relationship to You
 
       
  Signature  
I authorize investigation of all statements herein and release the camp and all others from liability in connection with same.  I understand that investigation will include verification of references, formal criminal background checks and sex offender database checks.  I understand that untrue, misleading or omitted information herein (including any attached resumes, other written materials or information provided during interviews) may result in dismissal, regardless of the time of discovery by the camp. 

By clicking on the submit button you are in essence providing your signature.
Please press the submit button ONCE and wait to see the confirmation page.