2015 4-H Teen Leader Camp Application

Due: Monday, November 25, 2014 NO LATE APPLICATION ACCEPTED Return completed application to: Howard County 4-H Camp 3300 N. Ridge Rd, Suite 240, Ellicott City, MD 21043 ALL APPLICANTS MUST ATTEND ONE TRAINING: December 6th 9am - Noon or December 14th 1-4p.m. Interviews will be held on Saturday, January 3rd

Name: ______Email: ______

Address: ______

Home Phone: ______Cell Phone: ______

Parent/Guardian Name: ______Cell Phone: ______

Birth Date: ______Age (as of 1/1/15): ______

Number of years you have previously attended Howard County 4-H Camp: ______

What other camps have you attended? ______

Leadership positions held at camp, 4-H, school, or in community. Please include as much information as possible:

Position applying for – please check:

Nation Leader (4-H age 16 & up with 2 years prior experience as a Teen Leader with at least 1 year as a Tribe Leader) The University of Maryland Extension programs are open to any person and will not discriminate against anyone because of race, age, sex, color, sexual orientation, physical or mental disability, religion, ancestry, national origin, marital status, genetic information, political affiliation, and gender identity or expression. Tribal Leader (4-H age 15 and up) Assistant Tribe Leader (4-H age 14 and up) Leaders In Training (LIT 4-H age 13 and up or 1st year)

What experience have you had working with youth other than Camp?

If you held a camp Teen Leader position last year, in what way did you help the campers have a memorable experience?

How would camp benefit by having you as a part of the staff?

Why are you applying for a position?

What do you feel you would gain from this camp leadership experience if accepted? If you were part of the leadership team in 2014, what did you gain from that experience?

The University of Maryland Extension programs are open to any person and will not discriminate against anyone because of race, age, sex, color, sexual orientation, physical or mental disability, religion, ancestry, national origin, marital status, genetic information, political affiliation, and gender identity or expression. 2015 4-H Teen Leader Camp Application

Do you have any suggestions for new activities or electives this year?

Please check the training and/or certificates you already have, if accepted for a position; a copy of your certificates must be placed in your file.

Red Cross First Aid Certification

Water Safety Instructor or Life Guard

Know basic Sign Language

Would you be interested in being a Teen Leader for a new Howard County Day Camp in addition to the Residential camp? YES NO

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