NOTE: All staff must be at least 18 years before the summer.
College graduates should complete a Senior Staff application.

First Name:		Gender:	Select OneMaleFemale
Last Name:		Social Security #:
Email Address:		Date of Birth:
School Name (if applicable):

Current Address:

Street Address:		State:	Select One Washington D.C. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Street (Line 2):
City:		Zip:
Phone Number:		Cell Phone Number:

Permament Address: (Leave blank if your current address is also your permament address)

Street Address:		State:	Select One Washington D.C. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Street Address (Line 2):
City:		Zip:

Please write what category position you are looking for? (For Example: Food Service, General Maintenance)
Please write what job specifically you are looking for in the category you wrote above: (Example: Head Chef, 2nd Cook, Landscaper, Mechanic, Dish Washer)
Please describe what experience you have that qualifies you for a maintenance or food service position:

Do you smoke:	Select One Yes No
Do you have any physical limitations that might limit the work you may be asked to perform:
Are you currently taking any RX drugs for a medical condition or recurring disease?:	Select OneYesNo
Do you currently have a driver's license?	Select OneYesNo
If you answered yes, what is the state and license number:
Select One Washington D.C. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Employment History

If you have not worked at a camp before, please list your employment for the past 3 summers or years below:

Dates of Employment (format as DD/MM/YYYY)	Employer	Street Address	City	State	Zip	Position Held
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-
-

Have you ever been convicted of any crime, including sex related or child abuse related offenses?	Select OneYesNo
If yes, please explain in detail:

Please answer the validation question: What is 2+2?