Camp Jack Paid Counselor Application 2024

*Required

PERSONAL INFORMATION:
First Name:* Middle Initial:* Last Name:* Address: * City:* State:* Zip:* Parish/Church:* Email:* What is your t-shirt size? Gender:* What age will you be by June 22, 2024: Social Media Accounts:* Mobile Phone:* Home Phone:*

Are you available the full week of camp from Saturday, June 22, at noon until Friday, June 28th, at 4:00 pm? * Are you available for mandatory staff training the full day of Saturday, June 22, 2024? *

EXPERIENCE WORKING WITH CHILDREN AND CAMPING EXPERIENCE
Total number of years you've worked with children: * Total number of years with camping experience as a staffer: *

Work Experience at a camp/other #1
Year: Camp: Position: Supervisor name and contact info:

Work Experience at a camp/other #2
Year: Camp: Position: Supervisor name and contact info:

SPECIFIC SKILLS:
Children's Ministry Leader: * Public Speaking:* Youth Ministry Leader:* Music Ministry Leader:* Lifeguard:* High/Low Elements:* First Aid/CPR:* Archery:* Arts & Crafts:* Campfire Programming:* Food Service:* Outdoor Group Games:* Maintenance:* Music:* Play an Instrument:* Singing (all types):* Swimming:* Storytelling:* Sound Mixing Board:*

CERTIFICATIONS

Certification #1
Certification: Provided By: Expiration:

Certification #2
Certification: Provided By: Expiration:

Do you have a legal right to be employed in the United States?:* How did you learn about Whispering Winds?:*

Being on our team means being in the outdoors for much of the day and living in rustic conditions. Camp staff live and work in close contact with trees and dirt, live closely with other camp staff and campers in camp-style quarters, share community bathrooms and may be required to help clean lodge rooms, assist with facilitating our challenge course (zip line, climbing wall, low elements), lead hikes, and perform other duties as assigned.

Are you able to perform these duties?:* If you will require accommodations to perform these duties, please describe:

EDUCATION - High School and College:
School #1 (MOST RECENT):
Dates Attended:* High School/College Name:* Address:* Phone Number:*
Major Subjects:* Degree/Year:

School #2
Dates Attended: High School/College Name: Address: Phone Number:
Major Subjects: Degree/Year:

School #3
Dates Attended: High School/College Name: Address: Phone Number:
Major Subjects: Degree/Year:

EMPLOYMENT & VOLUNTEER WORK
Employment/Volunteer Work #1 (most recent)*
Dates:* Employer/Supervisor:* Address:* Phone Number:*
Nature of Work:* Reason for Leaving (if applicable):*

Employment/Volunteer Work #2
Dates: Employer/Supervisor: Address: Phone Number:
Nature of Work: Reason for Leaving (if applicable):

Past Employment/Volunteer Work #3
Dates: Employer/Supervisor: Address: Phone Number:
Nature of Work: Reason for Leaving (if applicable): Please indicate any employer(s) you do not wish us to contact and the reason why not:

REFERENCES

Reference #1 Information
Name:* Relationship to You:* Day Phone:*
Evening Phone:*
Mobile Phone:*
Email:*

Reference #2 Information
Name:* Relationship to You:* Day Phone:*
Evening Phone:*
Mobile Phone:*
Email:*

DISCLOSURE AUTHORIZATION & RELEASE

1. I confirm that the information given on this application is correct. Accept?:* 2. I know of no limitation that would limit my full camp participation. Accept?:* Exceptions: 3. If I am selected, I agree to adhere to Whispering Winds’ Code of Conduct, camp policies, and programs, and I will give my full support and cooperation to other members of the camp staff, including volunteers. Accept?:* 4. Have you ever been convicted of a felony?:* If yes, please explain: 5. I agree to participate in any drug testing process and background check that may be adopted and to support Whispering Winds’ policy of a drug and alcohol-free camp. Accept?:*