First Name (*)
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Last Name (*)
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Current Address (*)
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City (*)
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State (*)
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Zip Code
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Phone (*)
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Cell Phone (*)
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Permanent Address (*)
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City (*)
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State (*)
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Email Address (*)
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Alternate Email
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Are You lawfully authorized to work in the United States? (*)
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Do you hold a current driver's license? (*)
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Will you be at least 18 years of age by June 1, 2012? (*)
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Staff TShirt Size Requested, if hired (*)
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Education
Name and Address of High School (*)
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Course of Study (*)
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Years Completed (*)
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Did you graduate? (*)
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Name and Address of College
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Course of Study
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List diploma or degree
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Years Completed
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Did you graduate college?
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Name and address of additional educational facility
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Other Course of Study
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List diploma or degree
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Years Completed
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Did you graduate?
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Record of Employment
Name and address of most recent employer
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Dates of Employment
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Describe the work you did
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Reason for Leaving
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Name and Phone Number of supervisor
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Name and address of previous employer #1
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Dates of Employment
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Describe the work you did
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Reason for Leaving
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Name and Phone Number of supervisor
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Name and address of previous employer #2
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Dates of Employment
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Describe the work you did
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Reason for Leaving
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Name and Phone Number of supervisor
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Name and address of previous employer #3
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Dates of Employment
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Describe the work you did
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Reason for Leaving
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Name and Phone Number of supervisor
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Camp Staff/Camper Experience
Please list your previous experience as a camper or camp staff. Include the year, position and camp name (if applicable). If not Amity Acres Day Camp include the name of the facility and its phone number. (*)
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Please list your previous experience as a camper or camp staff. Include the year, position and camp name (if applicable). If not Amity Acres Day Camp include the name of the facility and its phone number. (*)
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Please list your previous experience as a camper or camp staff. Include the year, position and camp name (if applicable). If not Amity Acres Day Camp include the name of the facility and its phone number. (*)
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First Reference Name (*)
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First Reference Position/Company
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First Reference Phone Number (*)
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First Reference City/State
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Second Reference Name (*)
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Second Reference Position/Company
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Second Reference Phone Number (*)
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Second Reference City/State
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Third Reference Name (*)
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Third Reference Position/Company
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Third Reference Phone Number (*)
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Third Reference City/State
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Certifications
Do you hold any certifications? For example, CPR by Red Cross.
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Do you know of any reason why you would not be able to perform the essential functions of the job position for which you are applying with or without reasonable accommodations? (*)
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If yes, please describe.
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Have you ever been convicted of a crime? (*)
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Date of conviction and location
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Choose first choice for position (*)
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Choose second choice for position
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Choose third choice for position
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What age group are you interested in working with? (Hold the Control Key if selecting multiple options) (*)
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Select the weeks you are available to work.(Hold the Control Key if selecting multiple options)
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I hereby acknowledge that I have read and understand the above statements and that I voluntarily sign the application. (*)
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I agree to begin the interview process by submitting this application with the understanding that if I am hired I am expected to attend STAFF TRAINING at a date to be determined soon. (*)
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