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 Primary Phone*Today's Date Are you certified as a lifeguard? Yes No Certification Expiration Date Are you 1st Aid/CPR certified? Yes No 1 st Aid/CPR Expiration date Nursing License number and StateOther Job Related Training/Certifications, Publications, Awards Position Desired*Preferred Age Range*None7-89-1011-1213-15Paragraph describing what you did well last summer, what you plan to improve on, what you learned from last summer, and how these things will impact your work at Joy in 2019*Any other pertinent information that we need to know (can’t work certain dates, want to use camp as an internship, etc.)* 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 youEmail address*Number of years knownProfessional Reference Name*TitleRelationship to youEmail address*Number of years knownFamily Reference Name*TitleRelationship to youEmail address*Number of years knownFamily Reference Name*TitleRelationship to youEmail address*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.