Camp Tecumseh:: Staff Application

Tecumseh’s staff is comprised of an experienced, caring team many of whom are lifetime educators and alumni. Several have been at camp for over 50 years! The ratio is of counselors to campers is approximately 1:4.

EMPLOYER 1
Employer 1:
Employer 1 Phone:
Employer 1 Fax:
Employer 1 Email:
Employer 1 Address:
Employer 1 Position:
Employer 1 Dates:
Employer 1 Salary:
Employer 1 Responsibilities:
Employer 1 Supervisor:

EMPLOYER 3
Employer 3:
Employer 3 Phone:
Employer 3 Fax:
Employer 3 Email:
Employer 3 Address:
Employer 3 Position:
Employer 3 Dates:
Employer 3 Salary:
Employer 3 Responsibilities:
Employer 3 Supervisor:

EMPLOYER 2
Employer 2:
Employer 2 Phone:
Employer 2 Fax:
Employer 2 Email:
Employer 2 Address:
Employer 2 Position:
Employer 2 Dates:
Employer 2 Salary:
Employer 2 Responsibilities:
Employer 2 Supervisor:

EMPLOYER 4
Employer 4:
Employer 4 Phone:
Employer 4 Fax:
Employer 4 Email:
Employer 4 Address:
Employer 4 Position:
Employer 4 Dates:
Employer 4 Salary:
Employer 4 Responsibilities:
Employer 4 Supervisor:

Please explain any gaps in you employment history:
Indicate any employer you do not wish us to contact, and the reason:

ACTIVITIES/INVOLVEMENT'S
(most recent 1st)

CAMP 1
Camp 1:
Camp 1 Location:
Camp 1 Program:
Camp 1 Years Attended:

CAMP 3
Camp 3:
Camp 3 Location:
Camp 3 Program:
Camp 3 Years Attended:

CAMP 2
Camp 2:
Camp 2 Location:
Camp 2 Program:
Camp 2 Years Attended:

CAMP 4
Camp 4:
Camp 4 Location:
Camp 4 Program:
Camp 4 Years Attended:


REFERENCES
(Please do not list any family members in this section)
REFERENCE 1
Reference 1 Name:
Reference 1 Address:
Reference 1 Email:
Reference 1 Phone:
Reference 1 Fax:

REFERENCE 2
Reference 2 Name:
Reference 2 Address:
Reference 2 Email:
Reference 2 Phone:
Reference 2 Fax:

REFERENCE 3
Reference 3 Name:
Reference 3 Address:
Reference 3 Email:
Reference 3 Phone:
Reference 3 Fax:


ACTIVITIES
The following material should give us some insight into you.
Click the box to the left of the activity you can assist in, or organize and teach.

LAND SPORTS
Baseball:
Basketball:
Field Hockey:
Lacrosse:
Roller Hockey:
Rugby:
Soccer:
Softball:
Street Hockey:
Volleyball:
Archery:
Badminton:
Croquet:
Golf:
Gymnastics:
Horseback:
Karate:
Riflery:
Tennis:
Weight/Fitness:
WATER SPORTS
Canoeing:
Kayaking:
Sailing:
Ski Boat Driving:
Swimming:
Water Skiing:
Windsurfing:

OUTDOOR ACTIVITIES
Backpacking:
Campfires:
Environmental Study:
Orienteering:
Outdoor Cooking:
Overnights:
Ropes Course:
Fishing:
ARTS AND CRAFTS
Ceramics:
Drawing:
Jewelry Making:
Leatherwork:
Native Crafts:
Painting:
Paper Mache:
Pottery:
Rocketry:
Sculpture:
Silk Screening:
Tie Dying:
Small Crafts:
Woodwork:

THEATRE
Choral:
Guitar:
Piano:
Acting:
Directing:
Magic:
Juggling:
Script Writing:
Costuming:
Electrical:
Lighting:
Makeup:
Set Construction:
Aerobics:
Choreography:
Folk Dance:
Modern Dance:
OTHER
Camp Newspaper:
Indian Lore:
New Games:
Storytelling:
Darkroom:
Photography:
Radio:
Video:

Other Activities:


CERTIFICATIONS AND CAMP SUPPORT
Staff Skills In the following list, please select "Skilled" for those items in which you have experience and skills. Select "Certified" for those which you hold current certification and send a copy of your certification.

BUSINESS/ADMINISTRATION
Bookkeeping/Accounting:
Computer/Technical:
Computer/Software:
Other (Please Specify) Business/Administration:
HEALTH/SAFETY
CPR:
First Aid:
Lifeguard:
Nursing:
Life Saving:
WSI:
Other (Please Specify) Health/Safety:

MAINTENANCE
Auto Mechanic:
Carpentry:
Electrical:
Plumbing:
Other (Please Specify) Maintenance:
FOOD SERVICE
Cooking/Meal Preperation:
Food Handler's Permit/Certification:
Menu Planning:
Purchasing:
Sanitation:
Other (Please Specify) Food Service:


DRIVER'S LICENSE
Answer these questions only if applying for a position requiring driving
Do you have a valid driver's license:	Yes No
Drivers License State:
Do you have current chauffer's-type license:	Yes No
Do you have a commercial driver's license:	Yes No


ESSAYS
At Camp Tecumseh we try to hire people who will make a difference. Write a brief biographical sketch, include any specialized training or related experience that may have a bearing on the position(s) for which you are applying:
Please list any relevant and up to date certifications you may have (For example: Lifeguard Certified, First Aid, etc...):

CONVICTION OR ACCUSATION
Harassment The camp's policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment.
* Have you ever been accused of harassment of any person including, but not limited to, workplace harassment:	Yes No
(Note: a prior accusation or conviction is not an automatic bar to employment. The type of conviction or accusation and when it occurred will be evaluated by the camp before any decision is made)
If yes please explain conviction or accusation:

CRIMINAL RECORD
* Have you ever been convicted of a crime, other than a minor traffic offense?:	Yes No
(Note: a prior conviction is not an automatic bar to employment. The type of conviction or accusation and when it occurred will be evaluated by the camp before any decision is made)
If yes please describe:

* I authorize investigatin of all statements herein, including any checks of criminal records, and release the camp and all others from libility in connection with same. I understand that, if employed, I will be an at-will employee unless there is an agreement or law which alters that status. Furthermore, I understand that any agreement must be in writing and signed by the designated camp official. I also understand that untrue, misleading, or omitted information herein or in other documents completed by the aplicant may result in dismissal, regardless of the time of discovery by the camp.
* Initial Here:


THIS FIELD HELPS PREVENT AUTOMATED ACCESS.

* Enter the code as it is shown:


PERSONAL INFORMATION
* First Name:
* Last Name:
Date of Application:
Earliest Date Available:
Email:

ADDRESS
PRESENT MAILING ADDRESS
Present Mailing Address Street and No.:
Present Mailing Address City and Zip Code:
Present Mailing Address State:
Present Mailing Address Country:
Present Mailing Address Telephone Number:
Present Mailing Address Fax:
HOME ADDRESS
Home Address Street and No.:
Home Address City and Zip Code:
Home Address State:
Home Address Country:
Home Address Telephone Number:
Home Address Fax:
Social Security Number:
Marital Status:

Latest Date Available:
What Position are you applying for:
Which Specialty:
Salary Requested:
Do you meet or exceed any minimum age requirements for that position:	Meet Exceed
Can you perform the essential functions of the job for which you have applied, with or without reasonable accommodation:	Yes No
If you are hired would you desire or need housing for any person(s) other than yourself at the camp:	Yes No
Do you have children:	Yes No
* Have you ever been accused or involved in an incident involving sexual or physical abuse of a child:	Yes No
If hired would you need housing for any person other than yourself at camp:	Yes No
If yes please explain:
Do you have children of camp age (7-15):	Yes No
Are you willing to live in a camper cabin as one of two or three staff members within that cabin:	Yes No

EDUCATION
PROFESSIONAL EDUCATION
Prof. Ed. Name:
Prof. Ed. Dates:
Prof. Ed. Degree/Major:

UNIVERSITY EDUCATION
Un. Name:
Un. Dates:
Un. Degree/Major:

HIGH SCHOOL EDUCATION
HS Name:
HS Dates:
HS Degree/Major:

Please explain any gaps in you education history:

WORK EXPERIENCE