2008 Staff Application for Employment

Please fill out the entire application to the best of your ability. Required fields must be completed to submit your application.

Employment Opportunities

Desired Position If Other, please specify:

Personal Information

Last Name: First Name:

Middle Name: Preferred Name:

Date of Birth (mm/dd/yy): Gender Male Female

Age: Marital Status Single Married

Driver's License Number:

Auto Insurance Company Name:

Insurance Policy Number:

Permanent Address:

City: State: Zip:

Email:

Telephone: Cell Phone:

School Address:

City: State: Zip:

School Telephone:

Please answer the questions. Explain questions if answered yes.

Have you received any moving violations within the past 3 years?
Yes No
Have you ever been convicted of a crime other than a traffic violation?
Yes No
Have you ever been convicted of sexual misconduct or sexual abuse?
Yes No
Have you ever been addicted to or treated for chemical dependence?
Yes No
Do you have any special conditions, problems or limitations that might interfere with your ability to perform the job for which you are applying? Yes No
If married, will you be attending camp with your spouse? Yes No
Will your spouse also be interested in working at Green River? Yes No
Will you have children attending camp with you? Yes No
Would you be interested in a camper tuition/salary trade? Yes No
Are you a past camper or staff member of The Green River Preserve? Yes No
Are you a past camper or staff member of another camp? Yes No
Are you available all summer? Yes No

If no, what dates are you available?

A counselor lives in a cabin with a group of children and is their leader.

Does this appeal to you? Yes No

What age group do you prefer? 8-10 years 11-12 years 13-14 years

Education

High School: Date of Graduation (mm/dd/yy):

Honors and Extracurricular Activities:

College: Date of Completion (mm/dd/yy):

Majors:

Degree Granted:

Honors and Extracurricular Activities:

Graduate School: Date of Completion (mm/dd/yy):

Majors:

Degree Granted:

Honors and Extracurricular Activities:

Volunteer and Employment History (most recent first)

Please list people, excluding relatives, who can make a statement regarding your work experience, character, and ability. Please be complete in lisiting information.

Employer: Address:
City: State: Zip Code:

Supervisor: Phone:

Type of Work:

Dates: From: To:
Employer: Address:
City: State: Zip Code:

Supervisor: Phone:

Type of Work:

Dates From: Dates To:
Employer: Address:
City: State: Zip Code:

Supervisor: Phone:

Type of Work:

Dates From: Dates To:
Employer: Address:
City: State: Zip Code:

Supervisor: Phone:

Type of Work:

Dates From: Dates To:

References

Name:

Relationship to you:

Address: City:

State: Zip Code: Phone Number:

Name:

Relationship to you:

Address: City:

State: Zip Code: Phone Number:

Name:

Relationship to you:

Address: City:

State: Zip Code: Phone Number:

Understand that The Green River Preserve has a practice of requesting a background check which could include protective services, criminal record check, motor vehicle check, and/or credit history report on prospective employees prior to contract confirmation.

Activities

Check the areas you feel qualified to instruct:

Nature	Teach	Assist	Some Experience	N/A
Animals
Astronomy
Birds
Botany
Conservation
Flowers
Geology
Ecology
Insects
Reptiles
Weather
Music and Performance	Teach	Assist	Some Experience	N/A
Singing
Dance
Theater
Story Telling
Guitar
Flute
Banjo
Drums
Outdoor Living Skills	Teach	Assist	Some Experience	N/A
Backpacking
Hiking
Outdoor Cooking
Camp Stove Use
Orienteering
Rock Climbing
Lead Climbing
Group Initiatives
Knot Tying
Arts and Crafts	Teach	Assist	Some Experience	N/A
Hand Pottery
Wheel Pottery
Painting
Drawing
Weaving
Basketry
Natural Materials
Land Sports	Teach	Assist	Some Experience	N/A
Archery
Skeet Shooting
Riflery
Fencing
Soccer
Group Games
Ultimate Frisbee
Aquatics	Teach	Assist	Some Experience	N/A
Swimming
Canoeing
Kayaking
Life Guarding
Fly Fishing
Fly Tying
Miscellaneous	Teach	Assist	Some Experience	N/A
Gardening
Native American Skills
Creative Writing
Video Production
Web Page/Photography
Nurse/Doctor
EMT
Office Work/Typing
Commercial Bus Driver

Please List in order of skill and preference the three activities you are most qualified to lead and/or assist.

First Preference:

Second Preference:

Third Preference:

A summer position at The Green River Preserve goes beyond general camp skills. It is a demanding job which uses interpersonal skills and personal resources. Please answer the following questions relating them to the specific position for which you are applying.

Questions

How would you describe yourself (background, strengths, weaknesses)?

Why are you interested in working for a camp, specifically The Green River Preserve?

Describe your experience(s) working with children, specifically gifted.

What contribution do you think you can make to insure a cohesive and purposeful program at The Green River Preserve?

Staff Shirts

Staff shirts are supplied to Employees.

T-Shirt Size: Polo Shirt Size:

Application Agreement

As part of the camp staff, you will be giving up a great deal of privacy and comfort, working long and demanding hours, and adhering to camp policies which may be limiting and not necessarily reflect your way of living (curfews, time on, time off, lack of privacy, etc.).

Any untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery by the camp. All statements become part of any future confidential employee personnel files. The Green River Preserve is an equal opportunity employer.

Applicant Agreement: This attests that you have answered all questions honestly and accurately and that you have no problem complying with the type of lifestyle indicated by the camp. It also gives permission for the camp to check references, criminal records, and driving records.

Applicant's Signature: Date:

Additional Comments