North Shore Day Camp : North Shore Staff : Apply Now!

An asterisk (*) denotes a required field


	First Name *		Last Name *

	Home Street Address *		Home Phone #

	Home City *		Cell / Current Phone # *

	Home State/Province *		Social Security Number * * Required for US Citizens

	Home Zip Code		Email Address *

	Home Country


	Date of Birth *		Gender
	/ /		Female Male
	Are You Married?		List Children (age/gender)
	Yes No
	How Did You Hear About Us?		Please Provide Names:

	Name of High School		Current Grade in High School

	Name of College		College Mailing Address

	Current Year in College		Major

- As Either a Camper or Staff Member (Not Required For Placement)


	Camp:		Director:

	Phone:		Dates:

	Salary:


	Employer's Name:		Contact Person:

	Phone:		Dates of Employment:

	Salary:



	Employer's Name:		Contact Person:

	Phone:		Dates of Employment:

	Salary:

Division Leader

Group Leader

Group Counselor

Specialty Counselor (Specify)

Kitchen

Other (Specify)

There may be an occasion where we will ask you to help out in a particular area. Consequently, we would like to know if you have a background in any or all of the areas listed below. Please select all of the areas that apply to you.

Please put 1 before the following activities you can organize and teach with some degree of proficiency, 2 for those activities you can assist in teaching, and 3 for those in which you have had some useful experience.
1 = ability to organize & teach
2 = ability to assist in teaching
3 = possess some useful experience

1	2	3	Sports
			Basketball
			Softball
			Soccer
			Tennis
			Lacrosse
			Baseball

1	2	3	Fitness
			Aerobics
			Cheerleading
			Martial Arts
			Yoga

1	2	3	Outdoor Activities
			Ropes Course
			Hiking
			Mountain Biking
			Overnights
			Horseback Riding English
			Go Carts
			Science & Nature

1	2	3	Watersports
			Swimming
			Diving
			Lifesaving
			Water Aerobics

1	2	3	(Performing) Arts
			Theater
			Dance
			Piano
			Guitar

1	2	3	Miscellaneous
			Radio/DJ
			Web Design Skills
			Digital Photography

1	2	3	Crafts & Electives
			Woodshop
			Ceramics
			Stained Glass
			Macrame
			Fabrics
			Model Making
			Tie-Dying
			Jewelry Making
			Painting
			Rocketry
			Candles
			Silk-Screen
			T-Shirt Design
			Masks
			Electronics/Robotics
			Cooking

1	2	3	Support Services
			Maintenance
			Grounds
			Carpentry
			Plumbing
			Chef/Cooking
			Salads/Pantry

Please let us know if you can teach or have talents in other areas (i.e. magic, juggling, etc.):

If you are applying for a specialty position, please indicate any training, teaching, coaching or other experience you have had in the specialty area.

Do you currently hold any of the following Certificates or Licenses? If so, please list expiration dates:

WSI		First Aid

Nassau Lifeguard Cert.		CPR/Type

BLS		Comm. Drivers License (CDL)


	Please indicate first and second choice.
	1st choice of age group of campers you prefer:
	2-4 5-7 8-12 13-15 Flexible
	2nd choice of age group of campers you prefer:
	2-4 5-7 8-12 13-15 Flexible

	Please indicate the dates you are available for camp:
	June - August , 2008
	You must be available from mid June until August 22, 2008

Please spend some time considering the following questions which will help us determine your ability to work at the position you have applied for.

What are your 3 best qualities?

If you were the director of a day camp, what would its philosophy be?

What are the most important things for a counselor to teach a young child?

If you could change anything in your life, what would it be?

Who are your two heroes/heroines?

Describe an unforgettable experience that you have had with a child.

Who referred you to work at North Shore Day Camp?

Have you ever been convicted of a felony or misdemeanor?	Have you ever been involved in an incident involving sexual or physical abuse to a child?

If you answered yes to either of the above questions, please explain the circumstances.

Do you have any physical condition or disease that would affect your ability to perform? If yes, please explain:

Yes

Staff members 21 years of age and older are generally required to drive a mini bus for us in addition to their in camp duties.
Are you 21 or older and willing to drive a mini bus?

Yes

Staff members under 21 may be needed as bus counselors.
Are you under 21 and willing to be a bus counselor?

Yes

PLEASE BE AWARE THAT WE CONDUCT BACKGROUND CHECKS ON ALL EMPLOYEES

Please review the above application before clicking the Submit button. Submitting this form will serve as your acknowledgment that the above information is correct.

Yes, I agree to allow North Shore Day Camp to do a background check and I affirm that all the above information is true to the best of my knowledge.* Required