Please send a current photograph of yourself. You may email it or mail it to:
First Name Middle Initial Last Name
Age (as of 6/1/2008) Date of Birth
Social Security # Driver's License # State
Religion Active Yes No
How did you find out about Camp Ton-A-Wandah?
Street
City State Zip
Phone
Email
Home Phone
High School Location Year of Graduation
College Major Current GPA Year
If college graduate, please speficy degree earned: Year
Graduate work/degrees Year
Camp dates, including pre-camp orientation are from June 1 - August 8, 2007. Are you available for the entire summer camp season? Yes No
If not, please indicate the dates/sessions you are available.
Staff Orientation (June 1 - June 7)
First Session (June 8 - June 27)
Second Session (June 29 - July 18)
Third Session (July 20 - August 8)
There is a compensation incentive rewarded to those able to commit to and complete full summer employment!
If you are applying to be a cabin counselor, what age group would you most like to be with? (Please rank from 1 - 3 with 1 being most interested and 3 being least interested.)
5 - 9 year-olds
10 - 11 year-olds
12 - 16 year-olds
Were you ever a camper? Yes No Camp Name Location Year
Were you ever a member of camp staff? Yes No Camp Name Location
Director Position(s) held Year
If former camper or staff member, what tribe?
Please list the most recent first.
Position(s) Employer
Address City State Zip
Phone Supervisor Inclusive Dates
Reason for Leaving
Have you ever been terminated from employment? Yes No If yes, please explain.
Please list 3 people (other than listed employers) who can make a strong statement about your abilities, character and work ethics. Do NOT include relatives. Please give complete mailing addresses and phone numbers.
Name Position
Please list any special conditions or limitations which might interfere with your ability to perform the job for which you are applying.
Have you ever suffered a nervous breakdown, depression or other mental disorders? If yes, please explain.
Are you under the care of a healthcare professional, doctor or counselor for physical or mental problems?
Camp Ton-A-Wandah can not employ a person using drugs, unless the medication is prescribed by a physician. Please list any prescription medications you are currently using and their purpose.
Insurance Carrier Group # Policy #
Camp Ton-A-Wandah offers a vast array of activity choices to their campers. Please indicate the activities you are qualified to Lead (plan, organize and teach) and those activities for which you would be able to Assist a qualified Lead Instructor.
WSI Instructor Lead Assist Cert. Date
Lifeguard Lead Assist Cert. Date
Lifeguard Instructor Lead Assist Cert. Date
Synchronized Swimming Lead Assist
Diving Lead Assist
English Seat Western Seat
Beginner Lead Assist
Intermediate Lead Assist
Advanced Lead Assist
Jumping Lead Assist
Horsemanship Lead Assist
Drama/Theater Lead Assist
Cheerleading Lead Assist
Storytelling Lead Assist
Karate Lead Assist
Puppetry Lead Assist
Dance - Modern Lead Assist
Dance - Ballet Lead Assist
Dance - Clogging Lead Assist
Dance - Tap Lead Assist
Music - Chorus Lead Assist
Music - Hand Bells Lead Assist
Instrument 1 Lead Assist
Instrument 2 Lead Assist
Instrument 3 Lead Assist
Nature Crafts Lead Assist
Fun With Science Lead Assist
Basic Lead Assist
WFA Certification Cert. Date
WFR Certification Cert. Date
Certifications
Years of Study
Photography / Dark Room Lead Assist
Digital Photography Lead Assist
Video / Video Editing Lead Assist
Camp Newsletter Lead Assist
Canoe Instructor Lead Assist
ACA Instructor Lead Assist Cert. Date
Lake Kayaking Lead Assist
Painting / Sketching Lead Assist
Basketry Lead Assist
Jewelry Making Lead Assist
Wood Burning Design Lead Assist
Ceramics / Pottery Lead Assist
Other Lead Assist
Archery Lead Assist Cert. Date
Riflery Lead Assist Cert. Date
Floor / Tumbling Lead Assist
Pilates Lead Assist
Aerobics Lead Assist
Kick Boxing (Tae Bo) Lead Assist
Yoga Lead Assist
Basketball Lead Assist
Volleyball Lead Assist
Soccer Lead Assist
Golf Lead Assist
Tennis Lead Assist
Cricket Lead Assist
Flag Football Lead Assist
Rugby Lead Assist
Lacrosse Lead Assist
Group Games Lead Assist
Climbing Wall Lead Assist
Ropes Course Lead Assist
Food Service Lead Assist
Camp Maintenance Lead Assist
Bus Driver Lead Assist CDL Cert. Date
Camp Canteen Store Lead Assist
Camp Retail Store Lead Assist
Program Office Assistant Lead Assist
Office Computer Skills Lead Assist
Web Site Navigation Lead Assist
Please list below the three activities that you would most like to teach at camp and why.
Before Staff orientation each year we offer advanced training for our staff. Please indicate any training that you may be interested in.
Riflery Instructor Training
Archery Instructor Training
Wilderness First Aid
Wilderness First Responder
Lifeguard Training
Rock Climbing Instructor Training
Ropes Course Instructor Training
Videography / Digital Photography Training
High School Clubs and Activities
College or Current Clubs and Activities (Academic, Sorority, Fraternity, Social, Charitable, and Athletic)
Other interests or hobbies
Do you prefer to work alone or with a group? Why?
What contribution do you think you can make in a camp environment?
What do you imagine will be your greatest difficulty at camp and why?
What are your personal characteristics? How would your friends describe you?
What personal characteristic would you most like to improve and why?
Why should a camp director select you to be a member of their summer 2008 staff?
Do you consume alcoholic beverages? Daily Weekly Seldom Never
Do you currently smoke? Yes No Occasionally
Camp Ton-A-Wandah is a smoke-free environment. Are you prepared not to smoke for the summer or on camp premises? Yes No
Have you ever suffered from an eating disorder? Yes NoIf yes, please describe.
Do you have any special dietary needs? Yes NoIf yes, please describe.(Special dietary needs can not always be accommodated.)
Are you a vegetarian or Vegan? Vegetarian Vegan
Do you have any visible body piercing or tattoos? Yes NoIf yes, where are they locate?
If yes, are you prepared to remove piercing(s) (other than earrings) for the duration of camp? Yes No
I hereby authorize investigation of all statements herein and release the camp and all others from liability in connection with same. I understand that, if employed, I will be an at-will employee and that any agreement to the contrary must be in writing and signed by the director of the camp. I also understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery by the camp.
Signature Type your name.
Camp Ton-A-Wandah is an equal opportunity employer and does not discriminate on the basis of race, color, sex, religion, disability, national or ethnic origin.
If you have friends who might be interested in working at Ton-A-Wandah this summer list them below and we will contact them!