| Name: |
Street Address:
|
| City:
|
State:
Zip: |
| Daytime Phone:
|
E-mail: |
| Social Security Number:
|
Birth Date: |
| Camp Selection
Henson Scout
Reservation Rodney
Scout Reservation Either
Camp |
|
Counselor
in Training (Must be 14 years old as of June 1) |
List four programs areas of interest: |
| Salaried
Staff Position (Must be 15 years or older as of June 1 - 15 year
olds must have served as a C.I.T. the prior year to be eligible for a
salaried position) |
| Please rank your position
preferences 1-4. Note: #-position requires minimum age 21
years *-position requires minimum age 18 years |
| Central Staff #Camp
Director #Program Director #Business
Manager #Chaplain #Head
Commissioner |
| Support Staff *Director
of Food Service *Cook
Dining Hall
Staff *Food Prep Dining
Hall Steward *Trading
Post Manager Trading
Post Staff *Quartermaster
*Ranger's
Assistant *Health
Officer Camp Clerk |
| Program Staff *Commissioner
#Aquatics
Director *Assistant
Aquatics Director *Sailing
Master Aquatics
Instructor *Aquatics
Instructor/Boat Driver *HAS
First Mate (RSR only)
#HAS Captain (RSR only) #Aquatics
Boatmaster (RSR only) *Brownsea
Director Brownsea
Instructor *Nature
Ecology Director Nature
Ecology Instructor *Handicraft
Director Handicraft
Instructor *Biking
(X-treme sports) Director Biking
(X-treme sports) Instructor #Project
COPE Director (HSR only) Project
COPE Instructor (HSR only) *Scoutcraft
Director Scoutcraft
Instructor #Shooting
Sports Director #Rifle
Range Officer *Archery
Range Officer Shooting
Sports Instructor Eagle
Base Director (HSR) Eagle
Base Instructor (HSR) #Ecotour
Director (HSR) *Ecotour
Instructor (HSR) #Shotgun
Range Officer (HSR) |
| Educational Background High
School Grade Level
completed College
Years completed Major
Degree Graduate
School Years completed
Area of Study Degree |
General Information (check
all that apply) Former
Camp Staff First
Aid Certified CPR
Certified Lifeguard
BSA/YMCA Red
Cross WSI National
Jamboree High
Adventure Base Number of years at Summer Camp
BSA National Camp School Certification in:
Cerificate Expires
List your school activities, sports participation, and community
involvement:
Number of years on regular paid staff in Delmarva Council (Not
counting any CIT years) Have you ever been convicted of a felony?
Note: Conviction of a felony is not an automatic bar from
employment. All circumstances will be considered, including what you
were convicted of, and how long ago the conviction occurred. Please
provide complete information about the conviction here.
Has your driver's license ever been suspended or revoked?
Are you a smoker?
Other than the above, is there any circumstance involving you
or your background that would call into question your being entrusted
with the supervision, care and guidance of young people?
If so please explain here |
| Employment History Current
Employer: Address:
City: State:
Zip: Phone:
Previous Employer:
Address: City:
State: Zip:
Phone: |
| Scouting Experience (check
all that apply) None
Cub Scout
Explorer or Venturer
OA APO
Junior Leader
Training Basic
Leader Training Woodbadge
Highest Rank attained
Current Registration(if any) Unit #
Council
Expiration date
If registered, current unit leader's name:
Phone: |
| Personal References 1.
Name:
Occupation: How
Known: Home
Phone:
Work Phone:
Years Known:
2. Name:
Occupation: How
Known: Home
Phone:
Work Phone:
Years Known: |
| Additional Information or
comments that you would like to make: |
|
Del-Mar-Va
Council, Inc. is an equal opportunity employer.
All camp staff employees are expected to be available for the
entire summer season.
Exceptions must be requested during interviews.
I
know of no reason why my health would limit full camp participation.
If employed, I will provide proof of a current physical
examination, and if not a currently registered member of the Boy Scouts
of America, I will register.
The
Boy Scouts of America can expect my loyalty to management, its policies,
programs, and my full cooperation with other members of the staff.
I also understand and agree that I will be a seasonal employee of
the Del-Mar-Va Council, Inc. on assignment as per my contract.
I
have read the above paragraphs and agree to their tenets. I
do not agree and do not wish for my application to be considered.
If
I am under 18 my parents or guardians have read the above paragraphs and
agree to their tenets. |
