Champion Day Camp - Online Staff Employment Application

Online Staff Employment Application

Name:
Permanent Address:
City: State: Zip:
Phone: E-mail:
College Address (if applicable):
City: State: Zip:
Phone:
Birthdate (MM/DD/YY):
Present year in high school or college if applicable:
How did you hear about Champion Day Camp?

Educational Background
School:
Dates Attended:
Major Subjects: Degree/Major:
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School:Dates Attended:
Major Subjects:Degree/Major:

Camp Experience
Camp: Summers Worked:
Position: Director:
Phone:
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Camp:Summers Worked:
Position:Director:
Phone:

Certifications
Do you hold any of the following certifications?

Issuing Agency:Expiration Date (MM/DD/YY):

Issuing Agency:Expiration Date (MM/DD/YY):

Issuing Agency:Expiration Date (MM/DD/YY):

Issuing Agency:Expiration Date (MM/DD/YY):
Other Certification:
Issuing Agency:Expiration Date (MM/DD/YY):
Other Certification:
Issuing Agency:Expiration Date (MM/DD/YY):

Special Interests or Skills

Do you have special talents or skills? List in the following with experience

     I also understand that untrue, misleading, or omitted information herein or in other documents completed by the applicant will result in dismissal, regardless of the time of discovery by the camp.