Quapaw Area Council Boy Scouts of America
Camp Rockefeller COUNSELOR-IN-TRAINING APPLICATION Gus Blass Scout Reservation 2018
(RETAIN THIS SHEET FOR YOUR OWN USE)
To all Scouts:
Opportunities to serve Scouting by being a member of the Camp Rockefeller Camp Staff are available to outstanding members of the Boy Scouts of America. Competition for employment is keen, the jobs are demanding, and the experience is exhilarating.
The minimum age is fourteen.
Applicants must be a registered member of the Boy Scouts of America.
The principle of the Scout Oath and Law must be practiced as a way of life.
The Staff must set an example of excellence in Scouting which includes the proper wearing of the Camp Rockefeller Staff Uniform.
Salary is based on the position’s responsibility with consideration given to the individual’s experience and level of responsibility.
A picture of you attached to the application is recommended.
References are important and a must! Applications will not be considered without references.
Counselors-In-Training are selected on as needed basis, based on desired week willing to work, number of other applicants, and number overall staff and camper attendance. Please indicate what week you have a preference to work. *No one will be selected to
The 2018 tentative contract period is from June 10, 2018 through July 7, 2018.
Mail your completed application to: 2018 Camp Staff Quapaw Area Council 3220 Cantrell Road Little Rock, AR 72202
Quapaw Area Council Boy Scouts of America
Camp Rockefeller CIT Application
Basic Personal Information Date: ______Name:______Date of Birth:______Address: ______City:______State:______Zip:______Telephone: ( )______Mobile Phone: ( )______E-mail:______Temporary Address (if applicable) ______Last date at this address:______
Current Scouting Information Place a check mark next to the current type of unit in which you are registered ____Troop ____Team ____Crew ____Ship ____Not Registered Unit Number:______District:______Rank:______
Indicate the length of time for your involvement with the following levels of Scouting Cub Scout:______Boy Scout:______Venture:______Adult Leader:______Current Leadership position held:______
Place a check mark next to your level of OA membership _____Ordeal _____Brotherhood _____Vigil Honor
Why do you want to work at camp? ______Quapaw Area Council Boy Scouts of America
Camp Rockefeller Summer Weeks 2018 Week 1: June 10 – June 16 Week 2: June 17 – June 23 Week 3: June 24 – June 30 Week 4: July 1 – July 1
Week Preference: I am interested in the following weeks at camp. They are listed in order of my preference. 1. ______2. ______3. ______4. ______
Having reviewed the minimum age requirements for the above camp positions, I will meet the minimum age for the positions I am applying for by June 12, 2018. Yes ______No ______
List the top ten merit badges and/or programs you feel most confident in teaching. 1. ______6. ______
2. ______7. ______
3. ______8. ______
4. ______9. ______
5. ______10. ______
Quapaw Area Council Boy Scouts of America
Areas of Knowledge, Experience, and/or Merit Badges:
Indicate with a check mark what merit badges (MB), experience, or training you have completed.
AQUATICS HANDICRAFT ECOLOGY Swimming MB Basketry MB CONSERVATION Lifesaving MB Indian Lore MB Env. Science MB Snorkeling Leatherwork MB Mammal Study MB Mile Swim Woodcarving MB Nature MB Rowing MB Welding MB Forestry MB Canoeing MB Music MB Weather MB Motor Boating MB Pottery MB Pulp & Paper MB Small Boat Sailing MB Astronomy MB Kayaking MB THE ARTS AND Reptile & Amphibian BSA Lifeguard TECHNOLOGY Study MB ARC Basic Rescue Communications MB Geology MB & Water Safety Public Speaking MB Bird Study MB ARC Advanced Computers MB Botany MB Lifesaving Cinematography MB Soil & Water ARC Water Safety Robotics MB Conservation MB Instructor Nuclear Science MB Fish & Wildlife MB ARC Water Safety Engineering MB Fishing MB Instructor Space Exploration MB Fly Fishing MB CPR Training Photography MB Insect Study MB Date______Video Editing CPR Instructor Graphic Design SHOOTING SPORTS Date______The S.T.E.M Program Archery MB Rifle Shooting MB SCOUTCRAFT OLDER BOY PROGRAM Shotgun MB Camping MB C.O.P.E. Participant Wilderness Survival Climbing MB PROGRAM EXPERIENCE Pioneering MB Mountain Biking MB Song Leading Geocaching MB Scout vs Wild Music Merit Badge Emergency Prep MB Spec Ops Campfires Search & Rescue MB Mountain Man Leading Games Orienteering MB Great White Buffalo Exp. Bugling Camping MB Extreme Aquatics Play and Instrument Outpost B.L.A.S.S. What Instrument(s)?
Quapaw Area Council Boy Scouts of America
MEDICAL EXPERIENCE ______Historian ______Medical Student ______Jr. Asst. Scoutmaster ______Paramedic
TRAINING EXPERIENCE ______Medical Doctor ______National Youth Leadership Training
______NYLT Staff ______Advanced First Aid Certificate ______National Leadership Seminar ______CPR Training ______Counselor-In-Training ______Leave No Trace Trainer ______Nursing ______AGFC Hunter Safety
Student ___LPN ___ RN______Archery Instructor Certification ______EMT ______NRA Instructor ______Wood Badge UNIT POSITIONS PREVIOUSLY HELD ______Wood Badge Staff ______SPL ______Scouter’s Key ______ASPL ______Commissioner College ______Patrol Leader ______Philmont Training Center ______Asst. Patrol Leader Philmont Training Course ______Scribe ______National Camp School Certification ______Quartermaster Certification Area: ______Webmaster Certification Date: ______
Camp Staff Experience:
Camp Year Position
Quapaw Area Council Boy Scouts of America
Education:
Name of College / School: ______Grade Completed: ______
Course/ Major: ______
Extra - Curricular Activities: ______
Leadership Positions: ______
Honors & Recognitions: ______
REFERENCES REQUIRED: Adult member of your troop, team, or post, or current employer: Name: ______Phone #: ______Address: ______City: ______State: ______Zip: ______Position or Title: ______
Community Leader (youth leader, religious leader, civic leader): Name: ______Phone #: ______Address: ______City: ______State: ______Zip: ______Position or Title: ______
Teacher, supervisor, or associate: Name: ______Phone #: ______Address: ______City: ______State: ______Zip: ______Position or Title: ______
Quapaw Area Council Boy Scouts of America
Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status or handicap. Due to the strenuous nature of some camp staff positions, medical certifications must be met by all camp staff members.
DECLARATION OF PRINCIPLES:
The principles of the Boy Scouts of America are based on the Scout Oath and Scout Laws and one is committed to the goal of teaching young people to make ethical decisions for the rest of their lives.
Do you agree with this declaration of principle? YES ______NO ______
Where you referred or recommended for hire by a Camp Commissioner, Director, or Staff member? YES ______NO ______
If yes, by whom were you recommended? ______
______Unit Leader Signature of Endorsement Date
______Applicant Signature Date
______Parent Signature Date (Parent’s signature required if applicant is under 18 years of age)
------(Office Use Only)
Date of Interview: ______
Considered for: ______
Interviewed by: ______