4-H Cit Teen Leader Camp Application

2017 4-H RETURNING CAMP COUNSELOR APPLICATION

Position – ONLY check Teen Director if you are eligible and interested in applying. Check all others that you are eligible. Teen Director (16-18 with 2 years’ experience as Tribe Leader) _____ Tribe Leader (15-18 years) _____ Assistant Tribe Leader/ Cabin Leader / Activity Leader (14-18 years) _____

Name ______Age as of JUNE 1, 2017 ______Birth Date ______Address _ Parents / Guardians Name ______Parent/Guardian Cell Phone or Home Phone __ _ Your Cell Phone __ _ Your Email Address _ _ Parent/Guardian Email Address _ _ School____ Current Grade ______Race Data: this information is requested on an optional basis. Your cooperation in providing it is appreciated. Please check the box that indicates your race which will be used only for reporting purposes. Native American _____ Asian :_ ____ Hispanic _____ Black _____ White _____] Other

Number of years attended 4-H Junior Camp as a Camper _____ Number of years attended 4-H Intermediate Camp as a Camper _____

List number of times you have served as each of the following, specifying Junior/Intermediate Camp: # times as Cabin / Activity Leader: _JR INTERMEDIATE CLOVER ____ # times as Tribal Teen Leader: JR INTERMEDIATE _____ # times Teen Director: _JR INTERMEDIATE ____

List Other Camp Experiences and Your Role (Day Camp, Sports, Girl Scouts, Boy Scouts, Specialty) .

List any Work (actually paid) Experience(s) and Your Role:

“A LEADER IS A TEAM PLAYER, A DOER, A HELPER, AN ENCOURAGER, AND A GOOD LISTENER.” Explain how you fit this definition and how it applies to your role as a Counselor.

What is your camping philosophy?

What do you feel is the role of ALL the adult volunteers at Camp, not just the Adult Camp Directors? How does your position as a Camp Counselor relate?

4-H and Extra-Curricular Activities: Include Leadership positions held with each activity listed e.i. Officer, Captain, Co-captain, Group or Committee Leader, Assistant positions held with an adult.

1. School:

2. Community:

3. 4-H other than Camp (Club, County, State)

4. Service Learning (Community Service):

5. Hobbies/Hidden Talents:

Describe any experiences working with younger youth, other than Camp. Include what you like most when working with younger youth and with what age group you prefer to work.

What are some of the reasons for conducting 4-H Camp, besides “FUN”?

What will you gain from your experiences as a Camp Counselor that will help you in future endeavers?

Do you think you are a good role model? Why?

If you are chosen as a Counselor, list at least three goals you hope to accomplish at Camp this year.

What is your favorite part of 4-H Camp and why do you think it is important?

What way did you help the Campers have a memorable experience at Camp last year?

What do you feel YOU need to work on to become a better Counselor this year?

If you could recommend a subject to be addressed at counselor training to help you in the counselor role at camp, what would it be? Explain.

Camp is physically, emotionally, and mentally stressful. How do you handle stress/pressure? Last year we implemented early curfews as one way to assist in managing stress. What other ways can we make the LAST TWO DAYS OF CAMP AS GREAT AS THE FIRST TWO FOR EVERY ONE ?

If you are accepted, which activities would you like to assist with? _____ Crafts _____ Riflery _____ Newspaper _____ Sports _____ Archery _____ Drama _____ Hiking _____ Outdoor Cooking _____ Nature Activities (specify) Robotics

**DIRECTOR APPLICANTS ONLY: Explain- What is the role of a Teen Director? What is your relationship to the Camp Adult Directors, other Counselors and Campers? Why should you be chosen for this position?

***NOTE: INTERVIEWS WILL BE CONDUCTED. NOT ALL APPLICANTS WILL BE CHOSEN. PREVIOUS PERFORMANCE WILL BE CONSIDERED. BEING A HIGH SCHOOL SENIOR DOES NOT AUTOMATICALLY MAKE YOU A TEEN DIRECTOR.

Training and/or certificates you already have: _____ Red Cross First Aid Certification _____ Red Cross Certified Life Guard _____ Water Safety Instructor _____ CPR Certification _____ Know basic sign language ____ Can Swim _____ Cannot Swim ___-__ Other (please list)

Please supply contact information for two non-family references. (We will be sending them a reference form to complete.)

Name / Title: ______Phone /Email/ Mailing Address __ _

Name / Title: ______Phone / Email/ Mailing Address __ ___

*** COST : Harford County 4-H Club Members $55 / Non-4-H Club Members $65 – Due 3/1/2017 ***DEADLINE FOR APPLICATION: NOVEMBER 14, 2016

Check Camps you will be AVAILABLE to attend. (You may not automatically be chosen for all camps you are available to attend.)

Intermediate Camp – June 25-June 30, 2017

Junior Camp – July 9-13, 2017

Clover Camp – July 5-7, 2017

In completing and submitting this application, I understand that there is an obligation to attend and participate in the planned camp staff trainings. I also understand that my selection to participate as a Camp Youth Staff Member is based upon many criteria as stated in the Applicant Agreement.

______Teen/ Applicant Signature Date

______Parent / Guardian Signature Date

The University of Maryland, College of Agriculture and Natural Resources programs are open to all and will not discriminate against anyone because of race, age, sex, color, sexual orientation, physical or mental disability, religion, ancestry, or national origin, marital status, genetic information, or political affiliation, or gender identity and expression. AGREEMENT FOR THE 2017 CAMP COUNSELOR APPLICANT (Copy of Signed Agreement with Original Signatures Must be Submitted by 1/1/17)

In completing and submitting this application, I understand that if selected to serve as a Teen Counselor I will be expected to attend and participate in 32 hours of mandatory meetings and trainings completed by June1, 2017 I also understand that my selection to participate as a camp youth staff member is based upon other criteria:  Submission of Application by November 14, 2016  Payment of Registration Fees by March 1, 2017  Checking References  Previous Camp and Leadership Experience  Completion of 4 Hours of Camp Service by June 1, 2017  Age, as stipulated under the ACA Camping Standards  Adhering to Camp and 4-H Behavior Expectations  Adhering to the University of Maryland, Maryland 4-H and Harford County 4-H policies and procedures. I also recognize the commitment and responsibility involved with being a 4-H Camp Counselor and I believe I am able to accept the challenge. I understand that my status as a Harford County 4-H Camp Counselor may be terminated at any time for failure to abide by these and other policies and procedures.

______Teen/ Applicant Signature Date

My child has my permission to apply to be a 4-H Camp Counselor for Harford County. I realize the responsibility the position holds. I feel my child can accept the commitment and follow through with all assigned tasks and duties.

______Signature of Parent/Guardian Date

The University of Maryland, College of Agriculture and Natural Resources programs are open to all and will not discriminate against anyone because of race, age, sex, color, sexual orientation, physical or mental disability, religion, ancestry, or national origin, marital status, genetic information, or political affiliation, or gender identity and expression.