Return Staff Summer Camp Application Summer Camp Returning Employment Step 1 of 5 20% 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 PhoneDate Lifeguard/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 Please fill out the following information if you are applying for a summer camp job. If you are applying for a non-summer camp job please hit NEXT BUTTON to complete the application. Counselor*NoneSenior CounselorJunior CounselorTeen Camp CounselorIf you would like to be a Junior, Senior, or Teen counselor please select one.Unit Leader*NonePurple (age 7-8)Orange (age 9-10)Green (age 11-12)Teen (age 13-15)A Unit Leader is a staff leader and responsible for leading campers, counselors and junior counselors. If you would like to apply to be a Unit Leader please select oneSupport Roles*NoneResident Camp CoordinatorSpeciality Camp CoordinatorTeen Camp CoordinatorCIT DirectorCIT Resource CounselorIf you would like to apply for a support role at Camp Joy this summer, please select one.Resource Counselor or Nurse*NoneResource StaffNurseIf you are applying as resource staff or nurse please click here.Program Specialists Music/Radio Nature Drama/Dance Recreation/Sports Survival/Myth Busters Fishing/Pond Archery Photography Other Please select all areas that you believe that you could lead or teach.Preferred Age Range*7-89-1011-1213-15Camp Runs May 29 - August 14 with some weekend work required - Please list any dates you are NOT available. 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 youPhone Number*Number of years knownProfessional Reference Name*TitleRelationship to youPhone Number*Number of years knownFamily Reference Name*TitleRelationship to youPhone Number*Number of years knownFamily Reference Name*TitleRelationship to youPhone 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 18PhoneThis field is for validation purposes and should be left unchanged.