Employment Application Camp Joy Employment Step 1 of 11 9% Name* First Last Email* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Cell PhonePosition Applied ForDate How did you hear about Camp Joy? May we contact you at work ?YesNoIf yes, what is the best time to call you at work?If you are under 18 and it is required. Can you furnish a work permit?YesNoIf no, please explain.Are you 21 or older?YesNoAre you legally eligible for employment in this country?YesNoDate available for work? What kind of job are you applying for?Full TimePart time Are you available to work evenings?YesNoIf no, please explainHave you ever been bonded?YesNoHave you ever been convicted of any sexual, physical or emotional child abuse, any crime related to children, or any other crime (not including traffic violations)*YesNoAnswering “yes” to the following does not constitute an automatic bar to employment. Factors such as date of offense, seriousness and nature of violation, rehabilitation and position applied for will be taken into accountIf yes, please provide date(s) and detailsCamp Joy is committed to a safe environment for its campers and employees. As part of our employment screening process, criminal background checks are conducted for all candidates. Criminal background checks promote a safe environment and help protect our campers, employees, and property. Please explain below any felony and/or misdemeanor convictions in Ohio or anywhere else. This includes any offenses to which you plead “no contest” and those where a judge has made an alternative finding (such as “pre-trial diversion”, “adjudication withheld”, or “deferred judgment”). Juvenile records, expunged offenses, and sealed records also must be disclosed, and are not an exception in our background check procedure. Camp Joy can access all of your conviction history. Note that the only type of offense that you do not have to disclose is a misdemeanor traffic offense (like a parking or speeding ticket) unless your job would involve driving for Camp Joy. If you aren't sure or have a question about whether something should be disclosed, you should disclose it. If you have not been convicted of or plead guilty to a felony or misdemeanor, please indicate “none.” In connection with my employment at Camp Joy, I authorize background checks of my criminal history. I release Camp Joy from all liability resulting from the furnishing of the information. I certify that my disclosures are true and complete to the best of my knowledge. I understand that any false statement or failure to disclose may eliminate me from further consideration for employment or result in termination of employment. Please describe any Conviction, Date, and Outcome. Employment History Starting with your recent employer, provide the following information. Current or most recent employerCompany Phone NumberCompany AddressStarting and final job titleSupervisor's NameStart Date End Date Reason for leavingSummarize the type of work performed and job responsibilitiesMay we contact this reference?YesNoLaterWhat did you like most about your position?What were the things you liked least about the position Second EmployerEmployer's NumberEmpoyer's AddressStarting/Final Job TitleSupervisor's NameStart Date End Date Why did you leave?Summarize the type of work performed and job responsibilities.May we contact this reference?YesNoLaterWhat did you like most about your position?What were the things you liked least about the position? Third EmployerEmployer's PhoneEmployer's AddressStarting/Final Job TitleSupervisor's NameStart Date End Date May we contact this referenceYesNoLaterWhy did you leave?Summarize the type of work performed and job responsibilities.What did you like most about your position?What were the things you liked least about the position? Qualifications and Certifications: (Check those applicable to position applying for.) List any special training, skills, licenses, current certificates, publications, and /or accomplishments (i.e. first aid, lifeguard, CPR, teaching, welding, food certifications, sales training) that may assist you in performing the position for which you are applying.Office/Computer Training/CertificationsYearsSafety TrainingYearsLifeguard/Water Safety Instructor: Certificate numberExpiration Date 1 st Aid/CPR Expiration date Certificate number and expiration dateNursing License number and StateOther Job Related Training/Certifications, Publications, Awards Educational Background Starting with your most recent school attended, provide the following information.School (Include City & State)Years CompletedLevel of Education CompletedDiplomaDegreeCertificateOtherGEDCompletion Date Major/MinorSchool (Include City & State)Year CompletedLevel of Education CompletedDiplomaDegreeCertificateOtherGEDCompletion Date School (Include City & State)Years CompletedLevel of Education CompletedDiplomaDegreeCertificateOtherGEDCompletion Date Volunteer and Community Service Experience / School Activities and Organizations Exclude memberships that would reveal race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran, National Guard or any other similarly protected statusOrganization's NamePositionNature of Work/ActivityTime PeriodOrganization's NamePositionNature of Work/ActivityTime PeriodOrganization's NamePositionNature of Work/ActivityTime Period References 4 References are required List name and telephone number of two professional references (please no current Joy staff) & two family member references. Professional Reference Name*TitleRelationship to youReference Email Address*Phone Number*Number of years knownProfessional Reference Name*TitleRelationship to youReference Email Address*Phone Number*Number of years knownFamily Reference Name*TitleRelationship to youReference Email Address*Phone Number*Number of years knownFamily Reference Name*TitleRelationship to youReference Email Address*Phone Number*Number of years known Joy Outdoor Education Center Applicant Release Form I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, résumé or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or Organizations for furnishing such information about me. I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law, race, color, religion, sex, national origin, disability, ancestry, age, income, ethnicity, sexual orientation, or marital of family status. I understand that this application remains current for only 60 days. At the conclusion of that time, if I have not heard from the Employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application. In the event of my employment by Camp Joy, I will comply with all policies set forth in the employee manual. I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the Employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard, submit to a pre-employment drug test, National Sex Offender Public Registry and fingerprinting. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to eliminate me from further consideration for employment, and/or may result in my immediate discharge from the Employer’s service, whenever it is discovered. I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.* Yes, I have read, fully understand and accept all terms of the foregoing Applicant Statement. Type Name and Date for Signature*Parent or Guardian Type Name and Date for Signature if under 18EmailThis field is for validation purposes and should be left unchanged.