Staff Application

In accordance with the Children's Online Privacy Protection Act a person must by 13 years of age or older to complete and submit this form.

Staff Applicants:

A counselor's responsibilities include teaching golf, supervising a dorm group of campers & participating in our various electives & activities.

Advantages to Working at our camp:

Dorm Living...2 to a room
4 indoor tennis courts for evening recreation
Every other night off
Every other weekend off from Friday 2pm thru Sunday 10am
Kayak on the Housatonic River
Excellent food...the Kent School takes good care of us.

If you are seriously interested in working at our camp, fill out the application below:

Position you are applying for:	tennis counselor golf counselor lifeguard health staff
	tennis counselor golf counselor lifeguard health staff

(these are the only positions which we are currently hiring)

Name:
Home Address:
Home City:
Home State/Province:
Country:
Home Zip/Postal Code:
Home Phone:
Cell Phone:
E-mail address:
Age:
Date of Birth:
Gender:	Male Female
College:
Social Security #:
Drivers License #:
Drivers License State:
Current Address:
Current City:
Current State/Province:
Current Country:
Current Zip/Postal Code:
Current Phone:

How did you hear about us?

Do you smoke? Yes No

Are you a US Citizen? Yes No

If you are not a US Citizen, which organization are you planning to come over with?
Camp America
BUNAC
Other

Any special conditions which will enter into your accepting employment at camp? Yes No
If yes, please explain:

Have you ever been convicted of a crime, including traffic violations, or been imprisoned during the last 7 years? Yes No

Do you have any physical or mental disability that may limit your performance in the job you are applying for? Yes No
If yes, please explain:

Please indicate the earliest date you could begin working (pre-camp staff training begins on June 25) and the last day you would be available (camp ends on August 15):

Earliest Date: Last Day:

Previous Employment (include dates, phone numbers & e-mail of supervisors)

Employer 1

Place:
Dates:
Supervisor:
Work Phone:
Home Phone:
E-Mail:

Employer 2

Place:
Dates:
Supervisor:
Work Phone:
Home Phone:
E-Mail:

Employer 3

Place:
Dates:
Supervisor:
Work Phone:
Home Phone:
E-Mail:

Tennis/Golf rankings, special achievements, awards, high school & college teams:

Personal References - Excluding Family (may include coaches, teachers, etc.)

Reference 1

Name:
Relationship to you:
Work Phone:
Home Phone:
E-Mail:

Reference 2

Name:
Relationship to you:
Work Phone:
Home Phone:
E-Mail:

Reference 3

Name:
Relationship to you:
Work Phone:
Home Phone:
E-Mail:

With the understanding that your duties will include both instruction & supervision and that you will sometimes be working long hours in stressful situations, why do you want to be a camp counselor?

Are you prepared to work hard?

Comments to Joel:

Warning: By submitting this form, you are acknowledging that all information contained within is accurate. Failure to supply accurate information is reason for termination of employment.