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Staff Application
Staff Application
You may fill Canteen Roads Teen Travel Camp Staff Application by completing the form below.
Name:
Last Name:
Popularly Known As:
Present Age:
Date of Birth:
Month
Month
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Social Security Number:
Health Insurance Number:
Email:
Permanent Address
Street and No.:
City and Zip Code:
Telephone Number:
Present Address
Street and No.:
City and Zip Code:
Telephone Number:
SCHOOLING
High School
Name of School:
Certificate or Degree:
Year of:
Year
2008
2007
2006
2005
2004
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1931
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1915
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1913
1912
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1908
1907
1906
1905
1904
1903
1902
1901
1900
Present Grade:
Graduation: Month
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
Day
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2008
2007
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1989
1988
1987
1986
1985
1984
1983
1982
1981
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1979
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1975
1974
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1972
1971
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1967
1966
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1907
1906
1905
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1902
1901
1900
University or College
Name of University or College:
Present occupation
(if student state course and year):
Why do you want to go to camp?
For what position are you applying?
Trip Director
Counselor
Lifeguard – WSI
Nurse – RN
What experience have you had in the type of work for which you are applying?
State briefly your ideas concerning the personal qualities necessary to be a Counselor
CAMPING EXPERIENCE
As a Camper
(List most recent first)
Name of Camp:
Location:
What Years Attended?:
Name of Camp:
Location:
What Years Attended?:
Name of Camp:
Location:
What Years Attended?:
Please write about your skills, talents and hobbies:
Swimming Ability:
Non-swimmer
50 yards
100 yards
300 yards or better
Swimming or Life Saving Awards held:
Have you any disabilities which would prevent you from full participation in all Camp Activities?
Would it be convenient for you to come to Canteen Roads Teen Travel Camp for an interview? If so, when?
Month
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
Day
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Year
Year
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
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1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
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1921
1920
1919
1918
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1916
1915
1914
1913
1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
Will you be available for three days of pre-camp training at Camp, the end of June?
Yes
No
Salary per season at last camp (if any)
Salary expected per season
REFERENCES
Give the names of three persons who know you and know what you can do. If you have been on the staff of another Camp please include the names of the Director and any other persons in a supervisory capacity that could give us information about you. Other names for references should be former employers, other people who have had an opportunity to observe you in a working situation or school principals and teachers, in that order.
Reference Name:
Relationship:
Friend
Camp Director
Employer
School Teacher
Other
Street and No.:
City and Zip Code:
Telephone Number:
Email:
Reference Name:
Relationship:
Friend
Camp Director
Employer
School Teacher
Other
Street and No.:
City and Zip Code:
Telephone Number:
Email:
Reference Name:
Relationship:
Friend
Camp Director
Employer
School Teacher
Other
Street and No.:
City and Zip Code:
Telephone Number:
Email: