Southern Sierra Council, BSA Camp Staff Application

Note: This application is used to apply for all Southern Sierra Council Camps staff positions, whether or not the staff position is paid or voluntary. Please complete all pages of the application and related forms and return to your Camp Director or the Southern Sierra Council Bakersfield Service Center.

Name: Date of Birth:

Mail completed application to: Social Security Number:XXX-XX-

Southern Sierra Council Camps Street Address: City, State, Zip: 2417 M Street Bakersfield, CA 93301 Phone: Email address: Phone: 661-325-9036 Shirt size: Fax: 661-325-2122 Council / District:

For Council Use Only:

Camp:

Position:

Responsible To:

Hourly Rate: $

# Hours Per Week: # Weeks Employed:

Start Date: End Date:

Council Approved for Hire: Information about Employment

The Southern Sierra Council operates a variety of assignment; some are as long as ten weeks and camps to meet the needs of the youth in Central others are less than a week. The maximum payroll . These Include long-term resident hours per week is 48 hours. camps for Boy Scouts and short-term resident camps for Cub Scouts, families and third-party Applicants must be registered members of the Boy groups as well. Scouts of America or agree to become registered before employment begins. Opportunities to serve Scouting as a member of a Southern Sierra Council Camp Staff are available The principles of the Scout Oath/Promise and Law to outstanding applicants. The application process must be practiced as a way of life. is competitive; the jobs demanding; the experience exhilarating. The staff is expected to set an example of excellence in Scouting, which includes the proper Applicants are considered for positions without wearing of the uniform, and adhere to standards regards to race, color, religion, sex, national origin, of personal appearance. age (unless there is a job specific age requirement), marital status, sexual orientation, Compensation is based on position responsibility veteran status or the presence of a health problem with consideration given to the individual’s or handicap that is unrelated to their ability to experience. perform the jobs requested. Review the list of positions and indicate three The minimum age requirements vary from preferences on the application. Applicants are position to position. Minimum employment age is encouraged to attach resumes but resumes are 15. Counselors in Training are age 14 and older. not required. Some positions require certifications and trainings. Applicants must be of minimum age Some positions require some vehicle driving. You and have any certificates and trainings required must have a valid driver’s license to qualify for completed by the first day of work for the position such a position. they have excepted. All certifications must be valid during the entire employment period. Submit your application early, as positions are filled based on need and qualifications. The Camp This Southern Sierra Council camp staff Director or the Southern Sierra Council will notify application, employment agreement, medical you when a decision is reached regarding your forms, and Boy Scouts of America Adult/Youth application. Application are required to be completed and on file with the Southern Sierra Council prior to The Southern Sierra Council, BSA is employment for all staff, regardless of whether an EQUAL OPPORTUNITY EMPLOYER. position is salaried or voluntary.

All applicants for paid positions are also required to complete Form I-9 “Employment Eligibility Verification,” and provide the required documentation in addition to the staff application and employment agreement.

The length of employment varies with job Please check the areas where you have experience (merit badge or other).

Aquatics ____ Canoeing ____ Small-Boat Sailing ____ Water Safety Instructor ____ Kayaking ____ Water Sports ____ Lifesaving ____ Lifeguard BSA ____ CPR Training ______(Date) ____ Rowing ____ Red Cross Basic Rescue ____ Swimming ____ Red Cross Adv. Lifesaving ____ CPR Instructor______(Date) ____ Sailing ____ National Camping School Aquatics Bouldering ____ Bouldering exp______Spotter exp______Climbing Certification Level: ______C.O.P.E. Level: ______Computer Knowledge ____ Excel ____ Customer Service Experience ____ Word ____ Receptionist Experience ____ Filing Cultural ____ Archeology ____ Scouting Heritage ____ Indian Lore & American Culture ____ Basketry ____ Citizenship in the Nation ____ American Heritage ____ Leather Work ____ Citizenship in the World Handicraft ____ Art/Animation ____ Chess ____ Beadwork ____ Basketry ____ Journalism ____ Woodcarving ____ Movie Making ____ Pottery/Sculpture ____ Game Design ____ Photography Healthcare ____ Medical Student ____ Adv. First Aid Certificate ____ Licensed Physician ____ CPR Training ____ Physician Assistant (PA) ____ Nursing: ___ Student ____ Paramedic ____ Licensed Vocational Nurse (LVN) ____ Emergency Medical Technician (EMT) ____ Licensed Practical Nurse (LPN) ____ Emergency Medical Responder (EMR) ____ Licensed Nursing Practitioner (LNP) ____ Registered Nurse (RN) Kitchen ____ Dishwashing ____ Kitchen Prep ____ Food Service ____ Order/Inventory Nature/Ecology/Science/Tech. ____ Astronomy ____ Fishing/Fly Fishing ____ Environmental Science ____ Bird Study ____ Geocaching ____ Plant Identification ____ Engineering ____ Nuclear Science ____ Space Exploration ____ Oceanography ____ Robotics ____ Weather ____ Mammal Study ____ Fish & Wildlife Study ____ National Camping School- ____ Forestry ____ Reptile & Amph. Study Ecology/Conservation ____ Insect Study Outdoor Skills ____ Camping ____ Search & Rescue ____ Mountain Biking ____ Cooking ____ Emergency Preparedness ____ Orienteering ____ Fire Safety ____ Soil & Water Conservation ____ Wilderness Survival ____ First Aid ____ Backpacking ____ National Camping School-Outdoor Skills ____ Pioneering (ODS) or 1st-Year Camper Training Program/Other Skills ____ Song Leading ____ Campfire Programs ____ Musical Instrument/ Vocal experience in a ____ Traffic Safety public setting (list ability/instrument) ____ Personal Fitness ______Signs, Signals, and Codes ______Leading Games ______Sports ____ Communications ____ Flag Retirement ____ Public Speaking ____ Other ______Music & Bugling ______High Adventure Expedition ______Story Telling ______Shooting Sports ____ Archery ____ Rifle Shooting ___ National Camping School______(Date)

____ Muzzle ____ Range Safety Officer ___ Other______loading Rifle (RSO) ______Shotgun ____ Chief Range Safety ______Shooting Officer (CRSO) Trade/Maintenance/Clerical/Ordination ____ Automotive Maintenance ____ Welding ____ Plumbing, Sanitation, Wastewater ____ Boat Operation ____ Carpentry Experience ____ Chainsaw Use Experience ____ House Keeping ____ Home Repairs ____ Electrical ____ Office/Clerical Experience ____ Heavy Machinery Experience ____ Retail/Sales Experience ____ Tractor Operation ____ Framing Experience ____ Food Service Experience ____ Plumbing – Supply lines ____ Inventory ____ Chaplaincy Management Experience Resident Camp Requirement Codes: Position ACE d, g, h, w, x, y, ab, ac, an, ao, aw, ax, az, bc, bd, bi Alpine Adventure Academy c, g, h, w, x, y, z, ac or ad or ae, ai or bi (desired), av, bc, bd, bg, bh, Archery Staff c, v (desired), w, ab, aw, ax, az, bb, bi Assistant Program Director c, g, h, i, j, w, ab, az, bc, bd, bi Aquatics Director b, I, w, x, y, ab, ag, ap, aw, ax, az, bc, bd, bi Aquatics Director Assistant c, I, g or k, h or l, w, x, y, ap or aq (desired), aw, ax, az, bc, bd, bi Aquatics/Waterfront Program Aide c, i, e, g, h, x, y, ab, aw, az, az, bc, bd, bi Camp Director b, g, h, I, j, w, af, aw, ax, az, bc, bd, bi Camp Commissioner c, g, h, w, am, aw, ax, az, bi Chaplain b, g, h, w, aw, ax, az, bi Construction Manager b, g, h, i (desired), j, w, aw, ax, az, bf Construction Team Lead c, q, h, w, aw, ax, az, bf Construction Team Member c, g, h, w, aw, ax, az, bf Cook c, g, h, m, w, aw, ax, az, bi Counselor-in-Training f, w, ab, aw, ax, az, bj Dining Hall Steward e, g (if 18+), h (if 18+), m, w, aw, az, az, bi Dishwasher e, g (if 18+), h (if 18+), m, w, aw, ax, az, bi Ecology/Conservation Director c, g, h, w, ab, ad, ae – will except ac, ak, aw, ax, az, bi Ecology/Conservation Program Aide e, w, ab, aw, ax, az, bi Food and Commissary Officer e, g (if 18+), h (if 18+), m, u aw, ax, az, bi Food Service Manager b, g, h, n, w, aw, ax, az, bi Handcraft Director c, g, h, w, ab, aw, ax, az, bi Handcraft Program Aide e, w, ab, aw, ax, az, bi Harbor Master c, g, h, i, w, x, y, aw, ax, az, bc, bd, bi Harbor Staff c, g, h, i, w, x, y, aw, ax, az, bc, bd, bi Health Officer c, k, p, w, aw, ax, ay, az, bi Improvement Team Lead c, g, h, j, o, aw, ax, az, be, bf, bi Improvement Team Member c, g, h, j, o, aw, ax, az, be, bf, bi KWEST Lead c, h, w, x, ac or ad, an, ao, aw, ax, az, bc, bi KWEST Staff c, h, w, x, ac or ad, an, ao, aw, ax, az, bc, bi Life Guard d, g, h, i, w, x, y, ab, ap or aq, aw, ax, az, bc, bd, bi Mountain Bike Lead d, g, h, w, ab, av, aw, ax, az, bh, bi Office Manager c, k, p, w, aw, ax, ay, az, bi Outdoor Cooking Coordinator e, g (if 18+), h (if 18+), m, w, aw, ax, az, bi Outdoor Skills Director c, g, h, w, ab, ac (desired), aj, aw, ax, az, bi Outdoor Skills Program Aide e, w, ab, aw, ax, az, (an, ao if 16+), bi Prep Cook e, g (if 18+), h (if 18+), m, w, aw, ax, az, bi Program Director b, g, h, i, j, w, ab, al, aw, ax, az, bc, bd, bi Provisional Scoutmaster c, g, h, w, aw, ax, az Range Safety Officer - Firearms c, g, h, g or r, w, ab, aw, ax, az, bi Ranger b, g, h, i, j, o, w, x, y, aw, ax, az, bc, bd, be, bf, bi Ranger Staff c, g, h, i, j, o, w, x, w, aw, ax, az, bc, bd, be, bf, bi Ranger Staff – Sanitation & House Keeping e, g (if 18+), h (if 18+), m, w, aw, ax, az, bi Rifle Instructor b, g, h, s, w, ab, aw, ax, az, bi Shooting Sports Program Aide d, w, ab, aw, ax, az, bi Shotgun Instructor b, g, h, t, w, ab, aw, ax, az, bi Trading Post Clerk e, g (if 18+), h (if 18+), m, w, aw, ax, az, bi Trading Post Manager c, g, h, m, w, aw, ax, az, bi Welding Instructor c, g, h, w, ab, aw, ax, az, be, bf, bi

Requirement Codes Key:

a. Age 25 or older. b. Age 21 or older. c. Age 18 or older. d. Age 16 or older. e. Age 15 or older. f. Age 14 or older. g. American Red Cross Life Saver Adult Cardio Pulmonary Resuscitation (CPR)/Automated External Defibrillator (AED) or equivalent (Must have practical portion, contact camp management with questions). h. American Red Cross Basic First Aid or equivalent (Contact Management with questions). i. California Boater Card is required for California Residents (Not required for employees from other states). j. Class C Non-Commercial Driver’s License. k. American Red Cross Cardio Pulmonary Resuscitation (CPR)/Automated External Defibrillator (AED) for professional/rescuers and health care providers. l. American Red Cross first aid for the professional. m. Food Handlers Card. n. Food Safety Manager’s Card. o. Chainsaw Safety. p. Appropriate documentation for the credentials: 1. Licensed Physician. 2. Licensed Nurse Practitioner. 3. Nurse {Registered Nurse (RN), Licensed Practical Nurse (LPN), or Licensed Vocational Nurse (LVN)}. Nurse’s aides, Certified Nursing Assistants (CNAs), and assistants do not qualify. 4. Licensed physician assistants. 5. Paramedic. 6. Emergency Medical Technician (Basic, Intermediate or Paramedic). 7. Emergency Medical Responder (i.e., current state license from the state in which the camp is located or current Nationally Certified First Responder listed on the National Registry of Emergency Medical Technicians (www.nremt.org). q. National Rifle Association (NRA) Range Safety Officer (RSO). r. National Rifle Association (NRA) Chief Range Safety Officer (CRSO). s. National Rifle Association (NRA) Rifle Instructor. t. National Rifle Association (NRA) Shotgun Instructor. u. National Rifle Association (NRA) Muzzle Loading Instructor or NRA Co-op or National Muzzle Loading Rifle Association Instructor. v. United States of America Archery/ National Field Archery Association (NFAA) Level 1 or higher (Contact Management with questions). w. Hazardous Weather. x. Safe Swim Defense. y. Safety Afloat. z. Treck Safely. aa. Climb on Safely. ab. Merit Badge Counselor Training.

ac. Leave No Trace.

ad. Leave No Trace (LNT) Training.

ae. Leave No Trace (LNT) Master Trainer.

af. Camp Director or Resident Camp Administration Section of National Camping School (NCS) Card.

ag. Boy Scouts of America (BSA) Aquatics Instructor National Camping School (NCS) Card.

ah. Shooting Sports National Camping School (NCS) Card.

ai. Trek Leader National Camping School (NCS) Card. aj. Outdoor Skills National Camping School (NCS) Card or demonstrate equivalent skills (Contact Management with questions). ak. Ecology/ Conservation National Camping School Card or College students or teachers trained in such fields as forestry, soil or water conservation, fish and wildlife, earth science, ecology, environmental specialties, etc., are considered to have equivalent training or students who have completed their sophomore year in college with a major in one of the above fields and have worked actively for one or more summers in a nature center or conservation oriented staff position in a summer camp may be considered to have equivalent training. al. Resident Camp Program Director or Resident Camp Administration National Camping School (NCS) Card. am. Commissioner National Camping School (NCS) Card or other qualification (Contact Management with questions). an. Trained Spotter (Contact Management with questions). ao. Bouldering Facilitator (Contact Management with questions). ap. Boy Scouts of America Life Guard or American Red Cross Life Guard. aq. Boy Scouts of America Life Guard Instructor. ar. American Red Cross Aquatics. as. American Red Cross Water Safety Instructor.

at. COPE Level 1 Instructor.

au. Climbing Level 1 Instructor.

av. American Red Cross Wilderness or Remote First Aid.

aw. Youth Protection Training – Cub Scout/ Boy Scout Version (YO1) Annually. ax. Youth Protection Training – Version (YO2) Annually. ay. Completion of Camp Health Officer’s Training Course. az. Unlawful Harassment Prevention Training. ba. Recognized as a qualified clergyman, seminarian, or layman by his or her own church body and is 21 years of age or older. Alternatively, an individual who is at least 21 years of age, possesses mature judgment, and is approved by the Scout executive may fulfill this role.

bb. Training course pocket certificate for archery range master issued by a trained National Camping School (NCS) Shooting Sports Director or a USA Archery/Nation Field Archery Association Instructor.

bc. Pass the Boy Scouts of America (BSA) swim test at Huntington Lake at a swimmer rating.

bd. Successfully pass a written and/or practical assessment on operation of all vessels used in performance of job duties.

be. Successfully pass a written and or practical assessment on operation of all motor vehicles used in performance of job duties.

bf. Successfully pass a written and/or practical assessment on operation of all power tools used in performance of job duties.

bg. , ranger training, college accredited course, or the equivalent.

bh. Bike shop using Bike Safe Boy Scouts of America (BSA) guidelines or college accredited course or equivalent.

bi. Must register with the Boy Scouts of America (BSA) in crew 30 or at council level as required by the Boy Scouts of America (BSA) and pay registration.

bj. Must demonstrate proficiency. Please type or print

Name:

Driver’s license number and state where issued:

Name and telephone number of person to contact in an emergency:

Have you ever been convicted of a felony? (You may answer "no" if your conviction has been ordered sealed, expunged, or eradicated.) Yes No Convictions of a crime is not an automatic bar to employment --- all circumstances will be considered, including what you were convicted of and how long ago. Please provide complete information about the conviction by attaching a separate statement.

Choices of Employment: Position applying for Department

First Choice:

Second Choice:

Third Choice:

Give a detailed account of why you want to work at Camp Kern. Attach a separate sheet if necessary.

Dates available for employment - (be specific) - From: To:

List current certification and dates (National Camp School, First Aid, CPR, EMT, Rifle, Lifeguard, etc.):

Camping Experience (List long-term camps only) Number of years as Name of Camp Location Camper Staff Position(s)

Currently registered in Scouting as: Unit Type: Number:

Number of years in Scouting as a youth: As an adult: Current rank:

Scouting positions held: Please type or print Achievements:

Describe leadership experiences:

Are you a member of the ? Yes No Honor received:

Order of the Arrow positions held:

Educational Background

Name of school/college: Location:

Scholastic honors:

Sports:

Activities/Clubs:

Languages spoken other than English:

Hobbies, Special Interests:

Employment

Present or most recent employer: From: To:

Address: Phone number:

Job Title Supervisor's name:

Description of duties (Indicate significant responsibilities, accomplishments & contributions):

Are you legally authorized to work in the United States? Yes No

References: Give names and phone numbers of 3 or more persons (not relatives) who have knowledge of your character, experience and abilities. Provide a reference letter from each person listed using the provided form.

Name Telephone Staff must reside on site in quarters provided (usually 2-person tents or staff bunk cabins) for all resident camps. Management reserves the right to inspect quarters at its discretion.

I hereby make application for summer employment and in accordance with the principles of the organization, subscribe to the Scout Oath or Promise, Law and Declaration of Religious Principle. I agree to be loyal to and cooperate fully with all of the BSA policies, program, and management including those described in this application. If selected, I further agree to submit a completed Health and Medical record upon arrival in camp. I understand that a personal interview may be required before employment will be granted and that I must execute a signed staff agreement prior to employment.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I authorize all my previous employers, schools, and all other references to furnish the information requested. I hereby declare that the information provided by me in this application for employment is accurate and complete to the best of my knowledge. I understand that any falsification or misrepresentation in this application is cause for discharge.

Signature Signature of parent if applicant is under age 18 Date Reference Letter

Applicant Name

Applicant Positions applying for:

Please answer all questions honestly and accurately: What is the nature of your relationship with the applicant?

Is the applicant honest and trustworthy at all times?

If no please supply full details:

How would you describe the applicant’s overall work performance?

What would you say are the applicant’s strengths?

What would you say are the applicant’s development areas (eg. weaknesses)?

How likely are you to entrusting the care of your child(ren) to the applicant?

How likely are you to entrust cash or valuable assets to the applicant? How would you describe the applicants work style?

Please check which box best applies to the applicant: General Conduct Work Performance Attitude towards Work Initiative Time Keeping Relationships with Colleagues Relationships with Customers

If you Indicated applicant is “Below Average” or “Poor” for any category please state your reasons below:

On a scale of 1-10, 1 being least and 10 being most, how would you rank the applicants exhibiting the 12 values of the Scout Oath/Promise? (Select The Number with the Drop box below) Trustworthy Loyal Helpful Friendly Courteous Kind Obedient Cheerful Thrifty Brave Clean Reverent

Reference Information Signature

Print Name

Date

Company Name

Telephone Number

I would like to further discuss the applicant over Yes or No the phone. (Circle one)