Lake Greeley Camp - Senior Staff Application

Senior Staff at Lake Greeley Camp are college graduates who specialize in a particular area of expertise, as listed above.

Senior Staff applicants must be aged 24 and above.

Personal Information:

First Name:

Gender:

Last Name:

Social Security #: - -

Email Address:

Date of Birth:

School Name:

Current Address

Street Address:

City:

State:

Phone:

Zip:

Permanent Address

Street Address:

City:

State:

Phone:

Zip:

What is the best time to reach you?:

Height:(inches)

Weight:(lbs)

How did you hear about Lake Greeley Camp

Earliest Date Available

Latest Available Date

Do you Smoke:

Do you Swim:

Year in College:

College Major:

Are you married?

Are you currently taking any RX drugs?:

Will any Children be coming to camp with you?

If yes Number of children:

Childrens Details
	Age	Sex		Age	Sex
Child 1			Child 4
Child 2			Child 5
Child 3			Child 6

Is your spouse interested in working at camp? If Yes, please indicate what your spouse would like to do at camp

Do you have a valid driver's license?

If yes, What is the state and licence # :

State:
Licence #:

Can you drive a 15 passenger van?

if yes, what is the extent of your experience:

Do you have any dietery restrictions? if yes please Explain

Do you have any physical limitation that might limit your ability to watch over children at camp? If yes, please explain.

Desired Salary:

(Please keep in mind that room, board & laundry services are provided and our camp season covers 54 work days and a one week orientation. In addition, our camp permits staff members to accept gratuities. In the past staff members have received gratuities ranging from $300 to over $1400.

Certifications

Red Cross Certifications

First Aid			Lifeguard
CPR			WSI
Lifeguard Instructor			First Aid responder

What other certifications do you hold that might have bearing upon camp employment?

Please indicate the which position/s you would like to be considered for:

Activity Supervisor
Gymnastics Director	Tennis director
Radio/Video Supervisor	Drama
Program Director	Athletics Director
Evening Activities	Driver
Special Events Director	Trips Director
Attendance Staff	Pottery & Ceramics Director
Adventure Director	Pool and/or Lake Supervisor
Office Staff	Arts & Crafts Director

Divison Director
Juniors - Grades 1-5	Junior Girls	Junior Boys
Intermediates - Grades 6 & 7	Intermediates Girls	Intermediates Boys
Seniors - Grades 1-5	Seniors Girls	Seniors Boys

Please indicated the order you are interested in the above positions

First Choice
Second Choice
Third Choice

Please indicate what experience you have which is relevant to the position(s) you have selected:

List any courses that you have taken that would relate to working with children:

What do you think are the most important aspects to being a good Supervisor?

What contributions do you think you can make to the camp and the children?

What qualities/characteristics do you feel you possess which will make you an effective Supervisor?

Employment History

If you have not worked at a camp before, please list details of your last 3 jobs.

Date	Employer	Street Address	City	State	Zip	Position Held
-
-
-

References:

Please list names and telephone numbers of 3 people who have knowledge of your abilities, experience and character. Two of these references should be either school or work related the other can be a character reference. This section is required in order for your application to be considered for employment at Lake Greeley Camp

Reference 1:
Name:		Day time phone #:


Street:

		Evening phone #:
City:


State:
		Relationship:

Zip:

Reference 2:
Name:		Day time phone #:


Street:

		Evening phone #:
City:


State:
		Relationship:

Zip:

Reference 3:
Name:		Day time phone #:


Street:

		Evening phone #:
City:


State:
		Relationship:

Zip:

Previous camp employment

If you have worked at a camp previously, please complete the following information for each camp employment.

Camp Director Reference 1:
Name:		Camp Name :
Street:		Job Held:
City:		Camp Phone #:
State:		Start Date:
Zip:		End Date:

Camp Director Reference 2:
Name:		Camp Name :
Street:		Job Held:
City:		Camp Phone #:
State:		Start Date:
Zip:		End Date:

Camp Director Reference 3:
Name:		Camp Name :
Street:		Job Held:
City:		Camp Phone #:
State:		Start Date:
Zip:		End Date:

Have you ever been convicted of any crime, including sex related or child abuse related offenses?

If yes, please explain in detail:

SUMMER: 222 Greeley Lake Rd, Greeley, PA 18425 p. 570.685.7196
WINTER: P.O. Box 219, Moscow, PA 18444 p. 570.842.3739