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Staff Application
 

Please Note: If you press enter while filling out this form, it will automatically send this form to us. Use tab to move between fields.

Full Name:  
Email:  
Permanent Address:
Dates and Time Expected at this address:
Street and Number:
City:
State:
Country:
Zip
Phone:
Cell Phone:
School or Winter Address (if any) 
Dates and Time Expected at this address:
Street and Number
City:
State:
Country:
Zip:
Phone:
Staff Shirt Size:
Small Medium Large XLarge XX Large XXX Large
 
Education:
School 1
Years Attended:
School:
Major Subjects:
Degree Granted:
School 2
Years Attended:
School
Major Subjects:
Degree Granted:
Past Employment (List last 3 Employers)
Employer:
Employer Address:
Dates Employed:
Employer Phone:
Direct Supervisor:
Nature of Work:
Reason For Leaving:
Employer:
Dates Employed:
Employer Address:
Employer Phone:
 Direct Supervisor
Nature of Work:
Reason for Leaving:
Employer:
Employer Address:
Dates Employed:
Employer Phone:
Direct Supervisor:
Nature of Work:
Reason for Leaving:
Indicate any employer you would not like us to contact at this time.  
Camp Experience:
Camp Name:
Camp Address:
Dates:
Director:
Camper or Staff: Camper Staff 
Camp Name:
Camp Address:
Dates:
Director:
Camper or Staff: Camper Staff 
References. Please provide names and contact information for 3 persons (not relatives) having knowledge of your character, experience and ability. Give each of these individuals a reference form available on this site
Name:
Address:
Phone:
Type of Reference: Professional Personal 
Name:
Address:
Phone:
Type of Reference: Professional Personal 
Name
Address
Phone:
Type of Reference: Professional Personal 
Drivers License: Yes No 
License State:
Difficulty with Duties: Yes No 
If Yes:
Position Desired
First Choice
Second Choice
Age Group Most Desired to Work With: Junior Teen CIT 
Desired Salary:
Considering the camp program and positions applying for, what is your experience in the following
Recreational/ Outdoor Skills
Softball:
Soccer:
Archery:
Hiking:
Field Games:
Volleyball:
Outdoor Living Skills:
Low Ropes:
High Ropes:
Other:
Nature/ Agriculture
Barnyard Animal:
Pond Studies:
Environmental Education
Gardening:
Other:
Creative Arts:
Painting:
Nature Crafts:
Song Leading:
Story telling:
Play Directing:
Instruments:
Please List Instruments Played
Other:
Waterfront:
Life guarding:
Swim Instruction:
Kayaking:
Canoeing:
Water Games:
Other:
Other Activities:
Evening Programs:
Campfire Program:
Please List Certifications and Special Training (First Aid, CPR, Lifeguard Training, Archery, Ropes Course etc) listing dates received and expired:
What contributions do you think you can make at camp?
What contributions do you think a well-run camp can make to children?
Have you ever been convicted of a crime ?  Yes No 
If yes, please explain. Be very specific if the  instance involved a child.:
Write a brief biographical sketch including specialized training, or experience working with youth or other fields that might have bearing on the position for which you are applying. 
I Agree  Important: By clicking this checkbox signifies my agreement that to the best of my knowledge, the above information is factual and accurate. Further, I release Camp Howe to reference this information for it's accuracy.
 

In accordance with Massachusetts law, summer camps are required to obtain a criminal background report on all staff working with children. Part of the application process will require you to authorize 4-H Camp Howe to receive this information about you.

I authorize investigation of all statements herein and release the camp and all others from liability in connection with same. I understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery by the camp.

I also permit Camp Howe to use any images of me taken during the summer for publicity purposes. Further, I give permission for any photos I take during camp to be used by Camp Howe or external organizations if they are in the benefit and promotion of Camp Howe.

Note: All statements become part of any employee personnel files.
 

 
 
 
 
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