PRAIRIELANDS COUNCIL APPLICATION FOR SUMMER CAMP EMPLOYMENT

Applicants are not required to give any information on this form that is prohibited by federal, state, or local law.

This application will be given every consideration, but its receipt does not imply that the applicant will be employed.

Applicants accepted for employment are on a trial basis with a probationary period and if, in our judgment, it is found during this period that the employee is not adapted to the work assigned, or that the information given has been misrepresented, the employment may be terminated without reason.

In connection with your application for employment, an investigation may be made requesting information as to character and general reputation. Information as to the nature and scope of any investigation requested will be furnished to you, upon your written request.

______FIRST NAME MIDDLE NAME LAST NAME

______ADDRESS CITY STATE ZIP

______E-MAIL ADDRESS PHONE NUMBER

† Program Director * Must Be---- Highest educational institution attended?______† Aquatics Director* *21 or older Dates attended______degree______† Aquatics Instructor **18 or older † Scoutcraft Director** Have you attended a BSA National Camping School in the last five † Scoutcraft Instructor years, if so when and where?______† First Year Campers Director Certificate obtained?______† First Year Campers Instructor Do you hold any Red Cross certificates? (Please list the † Handicraft Director** expiration dates)______† Handicraft Instructor ______† Poncho Pond Director** ______† Poncho Pond Instructor † High Adventure Director* Are you currently registered as a or Scouter?______† Sports Director Position?______Rank?______† Ecology Director ** Other positions held previously? † Ecology Instructor ______† Field Sports Director* ______† Field Sports Instructor ______† Archery Director** Exact dates you will be available for employment? † Health Officer* From______to______† Assistant (Maintenance) † Camp Commissioner* PREVIOUS EMPLOYERS and/or PERSONAL REFERENCES † Dining Hall Stewart -LIST THREE- † Dining Hall Worker INCLUDE PHONE NUMBERS PLEASE † Trading Post Assistant ______† Counselor-In-Training ______† Other______BOY SCOUTS OF AMERICA AN EQUAL OPPORTUNITY EMPLOYER Staff Experience:______

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Summer Camps Attended:______

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Special Interests & Hobbies:______

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General Skills Merit Badges Earned Scout Experience † Story Telling † First Aid † † Song Leader † Emergency Prep † NLS/NOAC † Skits † Camping † Lodge Officer † Campfire Emcee † Cooking † National † Games Leader † Life Saving † Philmont/Sea Base † Hike Master † Swimming † BSA Lifeguard † Cooking Specialist † Wilderness Surv. † Jr. Leader Training Conf. † Innertube Boatswain † Pioneering † Religious Award † Sports______† Nature † 50 Mile Foot-A-Float † Musical Instrument † Canoeing † Totin' Chip † ______† Archery

WHY DO YOU WANT TO WORK AT CAMP?

______Applicant's Signature and Date ______If under 18, Parent's Signature