Job Application

Welcome to our Staff Application. Please take your time when filling out the form below.
We appreciate your interest in a job at Park Slope Day Camp.

Have you worked here before? Yes
No
No, but I've applied before
Position Desired :
Dates available:
First name:
Last name:
Nickname:
Gender:
Female
Male
Date of birth:
Age:
Place of birth:
Social Security Number:
Referred By:
T-shirt size:
S
M
L
XL
2XL
Address:
City:
State:
Zip:
Home phone:
Business/day phone:
Cellphone:
Email:
Do you have any Physical limitations:
Emergency contact:
Emergency phone:

Certifications
Have you earned any of the following certifications?:
Life Guard Training
WSI
CPR
First Aid
What kind of
CPR and/or
first aid are you
certified in?:
Other certifications:
Are you an EMT?:
Yes
No

Education
High School:
High School Graduation Date:
College:
College Graduation Date:
Degrees:
School Status:
Major:

Camp Experience
Camp 1:
Where you a member of the staff or a camper?:
Staff
Camper
Years attended:
Address:
Name of Camp Director:
Camp 2:
Where you a member of the staff or a camper?:
Staff
Camper
Years attended:
Address:
Name of Camp Director:
Camp 3:
Where you a member of the staff or a camper?:
Staff
Camper
Years attended:
Address:
Name of Camp Director:
What are your professional goals:
What age child do you work best with?:
Skills:
Swimming
Performance Arts
Clowning & Juggling
Tumbling
Arts/Crafts
Nature
Canoeing
Skateboarding
Drama
Yoga
Dance
What kind of dance?
Music
Musical Instruments
What kind of musical instrument do you play?
Baseball

Tennis

Soccer
Basketball
Videography
Office Skills
 
 
 
Do you have any other special skills that may enhance our camper's experience?:

Past Employment or Teaching Experience

Please list the 2 previous summers and/or years.
Employer 1:
Address:
Phone:
Position:
Responsibilities:
Dates:
Salary:
Supervisor:
Reason for leaving:
Employer 2:
Address:
Phone:
Position:
Responsibilities:
Dates:
Salary:
Supervisor:
Reason for leaving:
Employer 3:
Address:
Phone:
Position:
Responsibilities:
Dates:
Salary:
Supervisor:
Reason for leaving:
Employer 4:
Address:
Phone:
Position:
Responsibilities:
Dates:
Salary:
Supervisor:
Reason for leaving:
Employer 5:
Address:
Phone:
Position:
Responsibilities:
Dates:
Salary:
Supervisor:
Reason for leaving:
Indicate any employer that you do not wish
us to contact and
the reason why:

References

Please give names and addresses of 3 people (not relatives) having knowledge of your character, experience and ability.
Reference 1:
Address:
Phone:
Cellphone:
Relationship:
Reference 2:
Address:
Phone:
Cellphone:
Relationship:
Reference 3:
Address:
Phone:
Cellphone:
Relationship:
Do you have a valid drivers license?:
Yes
No
What State:?
Do you have a current chauffeur's type license?:
Yes
No
Do you have a commercial license?:
Yes
No

Why I would be a great Member of the Staff
Ways in which I would have an impact on the campers:
My personal strengths:
Valuable experiences that I have had:
Ways in which I may be helpful to a child:
What contribution do you think a well run camp can make to children?:

Misdemeanors/Felonies
Have you commited any misdemeanors?:
Yes
No
Explain the reason for the misdemeanor:
Have you commited any felonies?:
Yes
No
Explain the reason for the felony:
Have you commited child abuse?:
Yes
No
Explain the reason for the child abuse:

I authorize investigation of all statements herein and release the camp and all others from liabiity in connection with same. I understand that if employed, I will be an at-will employee and that any agreement to the contrary must be in writing and signed by the Director of the Camp. I understand that unture, misleading, or omitted information herein my result in dismissal, regardless of the time of discovery by the camp.
Name:
Date: