EDUCATION
PAST EMPLOYMENT (List previous five summers or years)
Indicate any employer you do not wish us to contact and the reason
CAMP EXPERIENCE
Staff
REFERENCES (Give names/addresses of 3 persons [not relatives or close friends] having knowledge of your character, experience and ability.)
Applicants 21 and older:
Are there any reasons you may have difficulty in performing any of the essential elements of the job for which you have applied? Yes No
If yes, explain:
Considering the camp program and position applying for, put numeral "1" before those activities you can organize and teach; "2" for those activities which you can assist in teaching; and, "3" for those which you are interested in.
Recreation/Outdoor Living Skills
Nature/Agriculture
Creative Arts
Waterfront
Certifications/Special Training (First Aid, CPR, Life Guard Training, Archery, Ropes Course, etc.): Please provide date when received and expiration date.
What contributions do you think you can make at camp?
What contributions do you think a well-run camp can make to children?
Write a brief biographical sketch, including specialized training experience or training in other fields which might have a bearing on the position for which you are applying.
In accordance with Massachusetts law, summer camps are required to obtain a criminal background report on all staff working with children. Part of the application process will require you to authorize 4-H Camp Middlesex to receive this information about you. I authorize investigation of all statements herein and release the camp and all others from liability in connection with same. I understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery by the camp.
Note: All statements become part of any employee personnel files.
4-H Camp Middlesex PO Box 185, 1031 Erickson Rd. Ashby, MA 01431 Tel: (978) 386-7704 Fax: (978) 386-7046 office@campmiddlesex.com