Form

2019 Counselor Application

Thank you for your interest in Cub Creek Science Camp! This application is for those looking to work with us as a Summer Camp Counselor in 2019.
Applicant Information
Full Name *

First Name Middle Name Last Name

Current Address *

Street Address
Apt / Unit #
City	State / Province
Postal / Zip Code	Country

Is the above address also your permanent address?

Yes No
Phone Number *

- Area Code Phone Number
E-mail *
You are applying to be a summer camp counselor at Cub Creek. Are you also interested in any of the following? *

Lifeguard Ropes Course Nurse's Assistant Camp Store
Do you have any current certifications? *

CPR First Aid Lifeguard
How did you hear about Cub Creek Science Camp?
Getting to Know You
Tell us about yourself! Be sure to include hobbies, interests, etc.?
Have you ever attended as a child or worked at a summer camp? If yes, please summarize this experience including outstanding people and memories. If not, tell us about some outstanding memories from your childhood summers and what you do in your summers now.
What would you like most to gain or achieve from working with us this summer?
When you hear "summer camp", what does that make you think of?
Do you have any experience working with anyone with a disability? If yes, please describe.
Do you feel you have any other experience that would aid you in being camp staff?
Education
High School Graduation Date

- Month - Day Year
All Cub Creek Science Camp employees MUST have graduated highschool in order to work with us.
College Name, City, and State
College Graduation Date

- Month - Day Year
Degree/Major
Clubs/Interests/Extracurriculars
You may also include to clubs and interests dating prior to college
Previous Employment
Please use "Employer 1" as your most recent/current work experience. Employer 2 should be y9our place of work prior to Employer 1.
Employer 1
Company Name
Company Address
Company Phone

- Area Code Phone Number
Supervisor Name

First Name Last Name
Start Date

- Month - Day Year
End Date

- Month - Day Year
Job Title
Description of Duties
Reason for Leaving (if applicable)
May we contact this employer for a reference?
Employer 2
Company Name
Company Address
Company Phone

- Area Code Phone Number
Supervisor Name

First Name Last Name
Start Date

- Month - Day Year
End Date

- Month - Day Year
Job Title
Description of Duties
Reason for Leaving (if applicable)
May we contact this employer for a reference
Please describe any additional employment that would be helpful for us to know regarding your experience with children, animals, summer camp, etc or any employers who are not recent who you would like us to know about.
Please account for any time in the last 5 years you were unemployed or not attending school by stating the nature of your activities.
References

These references should be people who know of your work ethic and character. They should not be family members or close friends.
Reference 1 Name *

First Name Last Name
How long have you known this person? *
What is your relationship to this person? *
Phone Number *

- Area Code Phone Number
Reference 2 Name *

First Name Last Name
How long have you known this person? *
What is your relationship to this person? *
Phone Number *

- Area Code Phone Number
Disclaimers and Authorizations
Have you been convicted of any crimes(s) other than traffic in the last 10 years? *
If yes, please indicate conviction dates and circumstances.
You must pass a background check to qualify for employment. Do you authorize us, Cub Creek Science Camp, to perform a background check on you? *

I Agree to Authorize
I confirm that this application is truthful and that I authorize Cub Creek Science Camp to investigate the truthfulness of this application. I understand that providing false information intentionally on this application gives Cub Creek Science Camp the right to void employment or reject this application. *

I Confirm the Information I provide is True
Please read the following before submittting this application: Cub Creek Inc. an equal opportunity employer. In reading and answering the above questions, please keep in mind that none of the questions are intended to imply any limitations, preferences, or discrimination based on any non-job-related information. By completing this application, there is no assurance of employment. However, if a suitable opening occurs, this application will receive consideration. Use of this form does not indicate there are positions available.
Should be Empty:

2019 Counselor Application

Applicant Information

Getting to Know You

Education

Previous Employment

References

Disclaimers and Authorizations