Applicant Information

First Name

Last Name

Age Birth DateSex

Email Address

Social Security NumberDrivers License (state & #)

Your Address at School

School Town State Zip

Date leaving School

School PhoneBest time to call

Home Address

Home Town State Zip

Home Phone

High School Date GraduatedGPA

College Date GraduatedGPA

MajorMinor

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Camp Experience-- Camper Or Staff

Camp Name Dates Position

Camp Name Dates Position

Camp Name Dates Position

Describe your camp experience, resposibilities and time you spent at each camp.

Organization Position Year

Organization Position Year

Organization Position Year

Other Details

Employer NameAddress

Phone PositionDates

Reason you left this position

Employer NameAddress

Phone PositionDates

Reason you left this position

Employer NameAddress

Phone PositionDates

Reason you left this position

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Camp Activities

Please use the below coding, do not leave any activity blank

• 1)Activities you can teach or organize
• 2) Activities you can assist in teaching
• 3) Activities that are just Hobbies
• 0) Activities you have no skill in

0 1 2 3 Canoeing	0 1 2 3 Geology	0 1 2 3 Song Leading	0 1 2 3 Arts & Crafts
0 1 2 3 Camp Cooking	0 1 2 3 Stars	0 1 2 3 Photography	0 1 2 3 Archery
0 1 2 3 Orienteering	0 1 2 3 Animal Care	0 1 2 3 Newspaper	0 1 2 3 Water Skiing
0 1 2 3 Overnight Camping	0 1 2 3 Plant Identification	0 1 2 3 Team Building	0 1 2 3 Swimming
0 1 2 3 Weather	0 1 2 3 Ecology	0 1 2 3 Drama	0 1 2 3 Sailing
0 1 2 3 Backpacking	0 1 2 3 Science	0 1 2 3 Games	0 1 2 3 Musical Inst.
0 1 2 3 Volleyball	0 1 2 3 Baseball	0 1 2 3 Rifelry	0 1 2 3 Fishing
0 1 2 3 Basketball	0 1 2 3 Soccer	0 1 2 3 BMX Biking	0 1 2 3 Row Boating

Additional Activities you can teach, hackisack, juggling, etc

List your top three skills that you are capable of teaching at camp. Select from the skills you marked on the activity list.

	Skill you can each at camp	Experience you have in this area
1
2
3

List Certifications & Expiration Dates (Water Safety Instructor,Lifeguard,CPR,First Aid,Riflery,Boat Safety,Sailing,Canoeing,Archery)

Personal Thoughts

What lessons do you feel your campers should learn at camp?

What skills Best qualifies you for this position?(training or experience with children)

What are your expectations of camp?

Tell us a little about your family?

Why do you think we should hire you?

How would you disipline a camper who was not considerate of other campers feelings?

What position at camp are you applying for?

 

Personal Characteristics- rate your personal charateristics #1-Hey thats me, #2- Sometimes thats me, #3- I never feel that way 0 1 2 3 Thankful 0 1 2 3 Nervous 0 1 2 3 Sad 0 1 2 3 Lonley 0 1 2 3 Outgoing 0 1 2 3 Self Starter 0 1 2 3 Misunderstood 0 1 2 3 Cooperative 0 1 2 3 Moody 0 1 2 3 Agressive 0 1 2 3 Follower 0 1 2 3 Determined 0 1 2 3 Flexible 0 1 2 3 Enthusiastic 0 1 2 3 Easy-going 0 1 2 3 Patient 0 1 2 3 Approachable 0 1 2 3 In Control 0 1 2 3 Understanding 0 1 2 3 Helpful List 3 of your most often felt moods.

Comlete the following, please include any details or exceptions

YES	NO
		I am in good health and have no physical limitations that would preclude me from doing an active job.
		I have tattoos.(size, location and picture)
		I have Piercings.(location and number)
		I Smoke cigarettes or cigars. (frequency)
		I regularly partake in illegal drugs (type & frequency)
		I belong to a Fraternity/Sorority (name & purpose)
		I drink Alcohol (type & frequency)
		I took the Emotional IQ Test and my Score was
		My Staff Shirt Should be size s,m,l,xl,xxl

Please list three reffrences[not friends or relatives] that have knowledge of your character, experience, and your ability to work with children.

Name Phone Relation

Name Phone Relation

Name Phone Relation

While you are at camp our camp Nurse is responsible for keeping and dispensing all perscription medications. What medications will you be giving her.

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Yes No I have read and fully agree with and understand the "Life at Swift Nature Camp, Councelors Guide" as well as the Councelor Job Description. Yes No Have you been convicted of a crime(s) other than a traffic violation in past 10 years? A prior conviction will not necessarily bar you from employment. The type and date of the conviction will be considered by the camp prior to employment Yes No Have you ever been convicted of a crime(s) in which a child was the victim? Yes No Have you ever been criminally charged with any crime related to the mistreatment, abuse, molestation or pornography of children? Yes No If Yes to any of the above, please explain Yes No May Swift Nature Camp conduct a personal background check: including contacting references as named, a driving record and a criminal background check as required for all positions? If NO why not? Camp is very hard work So Be Honest with Yourself Come to SNC for all the Right Reasons

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