Camp Androscoggin | Staff Application Form

First Name:

Last Name:

Email Address:

Date of Birth:

School Address:

City:
State:
Zip:
School Telephone:

Home Address:

City:
State:
Zip:
Home Telephone:

Occupation:

Current Year in School:

Name of School:

Major / Degree:

Spring Vacation Dates:

From:

To:

Summer Dates Available:

From:

To:

Previous Camp Experience as Camper or Staff:

Camp Name:

Camp Location:

Position:

Dates:

Past employment (Please list position, dates, employer, etc.)

Extra Curricular Activities & Interests:

Activities Check List: Select (1) for activities you have participated in; (2) for those you feel qualified to assist; and (3) for those you feel qualified to lead.

Athletics	Check List	Water Sports	Check List
Archery		Swimming
Baseball		Sailing
Basketball		Canoeing
Lacrosse		Fishing
Riflery		Water-skiing
Tennis		Windsurfing
Soccer		Kayaking
Street Hockey

Arts	Checklist	Outdoors	Checklist
Drama		Camp craft
Photography		Mtn. Biking
Radio		Nature
Animation		Ropes Course
Video		Rock Climbing
Music		Overnight Trips
Ceramics		Canoe Trips
Woodwork
Handicrafts

Which activities, in order of preference, would you like to teach:

Activity 1:

Activity 2:

Activity 3:

Activity 4:

Do you have:

WSI

Lifeguard Training

Expires:

First Aid:

CPR:

Expires:

Age of campers you prefer to work with:

Condition of Health:

Salary Desired (Keep in mind we supply room and board):

How did you hear about Camp Androscoggin?

Please describe your background in your activity area of choice:

Please describe your experience working with children:

Please explain your reasons for applying to Camp Androscoggin:

Please list 3 references (Include Addresses, Email Addresses & Phone Numbers - Please use current or past employers, teachers, coaches, etc. Family and friends cannot be considered.):

Thank you for your time and interest in Androscoggin. Please review your information and then click submit.