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staff
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CAMP NUHOP, INC. staff

JOB APPLICATION photo



Date of Application____________________________



PLEASE CHECK POSITION DESIRED



____ Counselor ____ Counselor-in-Training ____ Waterfront Director



Name__________________________________________ Social Security Number_______________________

Birth Date____________________________________ Driver's License Number________________________

Permanent Address (street)___________________________________________________________________

(city)_________________________ (state)_________ (zip) ____________ (phone)______________________

School/Business Address (street)_______________________________________________________________

(city)_________________________ (state)_________ (zip) ____________ (phone)______________________

(cell phone)______________________ Email Address______________________________________________

This job requires extensive walking and physical activity. Would you be able to fulfill these requirements for

periods of six hours or more?__________



Smoking or smokeless tobacco is not permitted while on duty. Could you comply with this policy?__________



Work Experience

Please list below all work experience. Start with most recent. Circle any camp related experience.



Employer Position Date City/State Phone









Campus Life

College or University Attended_________________________________

Date graduated or when you will graduate_________________________

What is your major field of study?___________________________ Minor?________________________

Please use the space below to tell us about yourself. Include your family, interests, clubs, organizations, etc. We are

interested in you!

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Personal Assessment



Have you ever attended a camp as a camper?_______ If so, what camp?____________________________________________



Why do you want to be a counselor at Camp Nuhop?___________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

What unique contributions will you bring to the Camp Nuhop staff that make you stand out from other applicants?________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Describe any experience (personal, paid, or volunteer) you have with individuals with disabilities. _____________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Describe any experience you have leading others.___________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Have you ever been accused of or involved in an incident involving sexual or physical abuse of a child?___________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________



Please check any current certifications you have

_____CPR _____Life Guard _____Water Safety Instructor

_____1st Aid _____WFR _____Other:__________



All applicants must be interviewed. Two letters of reference must be received prior to the interview. Please list the names of

the two persons from whom professional and character references are being mailed.



Name Relationship Phone

_____________________________ ________________________ (____)________________

_____________________________ ________________________ (____)________________



As a camp staff employee, I will be giving up a great deal of privacy and comfort, working long and demanding hours,

and adhering to camp policies which may be limiting and not necessarily reflect my way of living. If hired, I will accept all

responsibilities as described in the job description.



(Signature) _________________________________________________


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