Application Form

	Staff Application Form 2011	This is not a secure web-site, if you would like to print out a form and mail it in, please click here.
Scroll down through this form to see how long it is before beginning. You can't "save" partway through and finish later, so be sure you have time to complete it before you begin.

Contact Information

Full Name		Bird Name
Home or Permanent Address		E-mail Address
Address		Cell phone
Address
City, State, Zip
Country
Phone

College/Temporary Address
Address
Address
City, State, Zip		Dates at School
Country
Phone

Camp Sessions

Dates of Camp: All sessions begin on Sunday and end on Saturday except Session 6, which will consist of specialty camp. mini-camp and a Father / Daughter session (ending 8/16). Check all sessions for which you are applying.

Job Preference

- Select the position(s) for which you are applying:

Age Group Preference

Please select two (2):

Voyager
(2nd grade)
7 years old

Pathfinder
(3-4 grades)
8-9 years old

Trailblazer
(5-6 grades)
10-11 years old

Challenger
(7-8 grades)
12-13 years old

Explorer
(9-11 grades)
14-17 years old

Activity Abilities

- Indicate your ability and interest in participating in the following activities by numbering as follows those items listed below: 0=no ability or interest, 1=interested but need to learn, 2=able to assist, 3=qualified to teach.

Swimming

Riflery

Campcraft, OLS

Sports, Games

Canoeing

Fishing

Drama, Mime

Newspaper

Sailing

Archery

Photography

Music

Horsemanship

Nature

Drawing, Painting

Hiking

Outdoor Cooking

Rowing

General Crafts

Ropes Course

Sign Language

Orienteering

Other

Certifications

Check any certifications and/or instructor's ratings and list training and experience you have in the following or other areas: (Having taught an activity at camp does not mean you are "certified." Please mark these off only if you have received special training in the area.)

Personal References

Please give the names, addresses, and phone numbers of three people (no relatives) who have knowledge of your ability, experience, and character. This applies to return staff as well as to new staff. We are required by law to check references each year.

	Reference 1	Reference 2	Reference 3
Name
Address
Address 2
City, State, Zip
Country
Home Phone
Business Phone
E-mail

Education

Years	School	Major Subject	Degree(s) Granted

Previous Employment

Dates	Employer	Address/Phone	Nature of Work	Supervisor	Reason for Leaving

I am a New Applicant Returning Applicant

NEW APPLICANTS

- Please answer the following questions:


1. How did you become a Christian? What have you done in the past year to contribute to your spiritual growth?
2. Why do you want to be a part of the Camp Cedarbrook staff?
3. Describe any previous camping experience and/or other experience that you have had working with children.
4. What do you think a camp counselor/leader should be like? What kinds of leadership experience have you had?
5. What kinds of discipline do you think would be appropriate in the camp setting?
6. Have you ever been convicted of a felony or a misdemeanor or any crime related to the abuse, mistreatment, or molestation of children?	Yes No If yes, Please explain
7. Are there any reasons you may have difficulty performing any of the essential functions of the job for which you have applied?	Yes No Please explain. Include suggestions for reasonable accommodations that would enable you to perform the job for which you are applying
8. Do you have a legal right to work in this country?	Yes No If no, please explain
9. Are you between the ages of 18 and 70?	Yes No If no, please explain.

RETURNING STAFF

I understand that being a Cedarbrook staff member means serving, cooperating with the administration and other staff members, obeying camp policies, and sacrificing personal desires for the best interests of campers and the good of the camp. My chief aim will be to share Christ through word and the example of a Biblical lifestyle. I understand that the use of alcohol and/or tobacco, drug abuse, abuse of campers or other staff members and sexual immorality (homosexuality, adultery, fornication) are inconsistent with this lifestyle and incompatible with the goals of the camp, and that engaging in any of these behaviors or promoting them to others will result in my immediate dismissal from staff/camp.

I authorize investigation of all statements herein and release the camp and all others from liability 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 untrue, misleading or omitted information herein may result in dismissal, regardless of the time of discovery by the camp.

Camp Cedarbrook in the Adirondacks is an equal opportunity employer, providing equal opportunities to employees and applicants without regard to race, color, national origin, age, disability, or veteran status.

By clicking "Submit Form" I am indicating both that I understand and agree to the above.

Session:	#1	#2	#3	#4	#5	#6	Mini	F/D	Check One: Volunteer Staff Paid Staff
Begins:	7/10	7/17	7/24	7/31	8/7	8/14-19	8/14-17	8/19-21	Check One: Volunteer Staff Paid Staff
PRE-CAMP TRAINING will begin on Saturday, June 25, 2011. All staff is expected to be in camp by that date unless permission has been given to arrive later. Staff contract ends Monday - August 22, 2011.

Staff Application Form 2011

Home or Permanent Address

College/Temporary Address

Staff Application Form
2011