Girl Scouts Eastern Washington & Northern Idaho

Returning camp staff: Please contact the camp director prior to submitting this application.

You are welcome to add as much detail as possible in the boxes provided for your responses.

Personal Info

First Name Last Name
Current Address (Street, City, State, Zip)
Permanent Address (Street, City, State, Zip)
Current Phone Permanent Phone
Email Address
What is the best way to contact you?
What is the best time to contact you?

How did you hear about this opportunity?
Camp Four Echoes Website
Craig's List
Employment Website (please specify)
Job Fair (please specify location)
Friend (Who?)
Former Camp Staff (Who?)
Other (please specify)

Who else do you know that would like information about working at camp?
Name:
Phone:
Email:

Desired Position at Camp (Please indicate your top 3, in order of preference, based on AVAILABLE positions ONLY):
Camp Director
Assistant Director
Program Director
Leadership/Counselor-in-Training Director
Waterfront Director
Waterfront Specialist (Lifeguard)
Head Cook
Assistant Cook
Kitchen Assistant
Business Manager
Arts/Crafts Leader
Unit Leader
Unit Counselor

Do you meet the requirements for the desired position (age, experience, certifications, etc.)?
Yes
No

Are you?

Education
Name of High School
Graduated? Yes No

Name of College or Area of Study

Graduated? Yes No

Job History

1. Employer's Name & Location:
Position/Major Responsibilities:

Dates of Employment:
Supervisor's Name and Phone Number:
Reason for leaving:

2. Employer's Name & Location:
Position/Major Responsibilities:

Dates of Employment:
Supervisor's Name and Phone Number:
Reason for leaving:

3. Employer's Name & Location:
Position/Major Responsibilities:

Dates of Employment:
Supervisor's Name and Phone Number:
Reason for leaving:

Volunteer Experience/Membership in professional or civic organization related to this position (exclude, if you wish, those which may disclose your race, color, religion, or national origin.)
Organization:
Position/Duties:
Dates:

Are you a current Girl Scout: Yes No

Experiences as a Camper or Camp Staff Member:
Name and location of camp(s)
Position(s):
Year(s):
Sponsoring Organization:

Skills/Talents/Experience

Please list any current certifications you hold and list their expiration date:
(Example: First Aid, CPR Adult, CPR Child, CPR/AED Adult, CPR AED Child, Wilderness First Aid, CPR for Profesional Rescurer, Basic Water Safety, Samll Carft Safety, Lifeguard, Water Safety Instructor, Archery Instructor, or any other certifications.)

Please read the following list of camp skills. Indicate your level of proficiency for EACH:

Teach: Proficient enough to teach the subject
Assist: A working knowledge, but don't feel you can lead
Hobby: Some experience, interest, or curisoity on the subject

Environmental Education:	Teach Assist Hobby
Plant/Tree Indentification:	Teach Assist Hobby
Animal/Bird Identification:	Teach Assist Hobby
Theatre/Makeup:	Teach Assist Hobby
Creative Dramatics/Skits:	Teach Assist Hobby
Dancing:	Teach Assist Hobby
Singing:	Teach Assist Hobby
Song Leading:	Teach Assist Hobby
Games (sit down, circles):	Teach Assist Hobby
Games (field, active):	Teach Assist Hobby
Fire Building:	Teach Assist Hobby
Outdoor Cooking:	Teach Assist Hobby
First Aid:	Teach Assist Hobby
Knots:	Teach Assist Hobby
Knife Safety:	Teach Assist Hobby
Shelters/Tents:	Teach Assist Hobby
Orienteering/GPS:	Teach Assist Hobby
Swimming:	Teach Assist Hobby
Water Safety:	Teach Assist Hobby
Trips:	Teach Assist Hobby
Hiking:	Teach Assist Hobby
Backpacking:	Teach Assist Hobby
Canoeing:	Teach Assist Hobby
Sailing:	Teach Assist Hobby
Windsurfing:	Teach Assist Hobby
Challenge Course:	Teach Assist Hobby
Arts & Crafts:	Teach Assist Hobby
Other Interests:

References (REQUIRED)

Please list those references that are unrelated to you and can speak knowledgably about your ability to work with children and peers. Provide these people with a reference form found at http://www.gsewni.org/campstaffrerence.cfm. Reference forms may be completed online or printed and mailed in. At least two (2) completed references forms (in addition to a submitted letter of reference) must be received before an interview can be scheduled.

1. REFERENCE
Name
Phone Number
Position
Email Address
How do you know this person?
How long have you known this person?

2. REFERENCE
Name
Phone Number
Position
Email Address
How do you know this person?
How long have you known this person?

3. REFERENCE
Name
Phone Number
Position
Email Address
How do you know this person?
How long have you known this person?

Personal Statements

1. What ages do you prefer to work with?

2. Why do you want to work at camp?

3. Please describe your camping experience and skills.

3. What interpersonal skills do you have to offer this position ?

4. Do you meet the eligibility requirements for the position(s) for which you have applied?
Yes No

5. Are you willing to become a member of the Girl Scout Movement?
Yes No

6. Have you ever been convicted of a criminal offense in the last seven years: Yes No
If yes, please state the offense, date of conviction, location and disposition:

7. Are you a United States citizen or otherwise legally eligible for employment in the United States:
Yes No

8. Have you ever been discharged from an employer: Yes No
If yes, please explain:

9. Have you resigned from any position for misconduct or unsatisfactory service? Yes No
If yes, please explain:

By checking this box and submitting this application, I hereby certify that the answers herein are true to the best of my knowledge. If I am selected to participate in an interview, I agree to sign this application and allow Girl Scouts Eastern Washington & Northern Idaho to perform a criminal background check, contact previous employers and references and review public social networking pages such as MySpace.com and Facebook.com. I understand that the making of any false statements herein may result in denial of employment or discharge. If selected as a staff member, I agree to abide by the philosophies in the Girl Scout Promise and Law, register with the Girl Scouts of the USA, and to fulfill the responsibilities to the best of my ability. I understand that any employment with the Girl Scouts Eastern Washington & Northern Idaho is of indefinite duration and may be terminated at any time with or without cause, and with or without notice by either party.

Camp Four Echoes Staff Application