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.

*Required fields.

Personal Information

* First Name

* Last Name

Date of Application

Earliest Date Available

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

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