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CAMP COUNSELOR APPLICATION

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					           2012 Waubonsie 4-H Horse Camp Counselor Application

RETURN BY MAY 4, 2012, TO THE FREMONT COUNTY EXTENSION OFFICE,
BOX 420, SIDNEY, IA 51652; fax: 712/374-3286; or email to sharris@iastate.edu
Notification of application status will be provided by May 11, 2012.

Thank you for your interest in being a camp counselor for 4-H Horse Camp. Please read this application and
then complete it carefully. The selections will be based in part on the completeness and enthusiasm
expressed in the application. Counselors must be 16 or older by June, for camp and demonstrate a high level
of maturity. Counselors are expected be experienced riders, be able to help others using their equine
knowledge, and bring their own horse to camp. You will be responsible assisting a small group of campers,
ensuring proper tack adjustment and riding safety while gaining the respect of campers that you supervise.
You will gain leadership skills, pass forward your equine knowledge, meet new people, build lasting
friendships, and have fun!

Counselor positions are limited and camp registration fees are not required for those selected. All senior 4-H
youth are encouraged to attend camp and become challenged at a higher level of horsemanship.



NAME                                                        AGE (during camp)

ADDRESS

TOWN                                                                         ZIP

TELEPHONE                                                     COUNTY

GENDER                                         Email

YEARS RIDING                                           YEARS WITH HORSE
***YOU WILL BE REQUIRED TO ATTEND COUNSELOR TRAINING SESSION June 22rd, SCHEDULED
PRIOR TO THE CAMPERS ARRIVAL!! Counselors will need to be available for the entire 2012 WAUBONSIE
4-H HORSE CAMP, Friday June 22 – Sunday June 23, 2012 at the Fremont County Fairgrounds, Sidney,
Iowa. All counselors must also turn in medical forms.***
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PLEASE ANSWER THE FOLLOWING QUESTIONS:
  1. WHY DO YOU WANT TO BE A CAMP COUNSELOR?




                                                                                                                  1
     2. WHAT LEADERSHIP SKILLS DO YOU THINK ARE NECESSARY TO BE A
        GOOD CAMP COUNSELOR?




     3. WHAT DO YOU THINK THE YOUTH GAIN FROM THE CAMPING
        EXPERIENCES?




Please list 2 Non-Relative References that can attest to your skills with horses or
riding:
INCLUDE NAMES, ADDRESSES, PHONE NUMBERS AND EMAIL.

1.



2.



Signature of Applicant
SIGNED (4-H’ER)


RECOMMENDATION FROM LOCAL EXTENSION STAFF
Please ask your county 4-H staff to lend their recommendation to your application:




SIGNED (COUNTY 4-H STAFF) __________________________
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posted:2/27/2012
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