Camp Ford: Adventures in Leadership Counselor Application 2012

APPLICATION

During the camp, you will:
Connect with youth and other mentors, lead activities, learn leadership skills, sleep under the stars, see wildlife, play volleyball, get to know others, get to know yourself, raft the Klamath River, sleep under the stars, hike to Ukonom Falls, perform skits, learn the natural history of the area, eat great food, share stories by the campfire, find quiet time, do a service project, and live without your cell phone and ipod!

To be a counselor you must be a current high school sophomore or junior.

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* 1. First and Last Name:

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* 2. Gender

Male

Female

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* 3. Contact Information:

Address:

City:

State:

ZIP:

Cell Phone:

Home Phone:

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* 4. Email Address:

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* 5. Parent/Guardian:

Name:

Phone Number:

Email Address:

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* 6. What grade will you be entering in the fall of 2012?

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* 7. What High School do you attend?

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* 8. Date of Birth:

mm/dd/yyyy

Date

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* 9. Have you ever been a part of Camp Ford before?

Yes

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* 10. If yes, how?

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* 11. If no, how did you learn about the camp?

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* 12. Will you be available for the entire Camp Ford from July 28th-August 4th?

Yes

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* 13. What issues or opportunities do you see in your community to make it a better place to live, study and play?

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* 14. What are some of the things you like to do (for example: hobbies, clubs, sports, family life, and personal interests) and that you'd like to share with other campers?

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* 15. Share your experience working with youth, especially if you have experience with early teens.

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* 16. What are you expecting to get out of Camp Ford?

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* 17. What are your best leadership qualities that pertain to being a counselor at Camp Ford?

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* 18. Have you ever attended overnight camp before?

Yes

If so, which one?

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* 19. Have you ever been white-water rafting?

Yes

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* 20. Can you swim?

Yes

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* 21. Do you have any medical or physical conditions that would affect your ability to hike and raft?

Please submit two letters of reference. One must be from a teacher or principal, and the other can be from any adult, not related to you and who has known you for at least a year. Forms can be downloaded at www.tfff.org/campford and are due by April 20, 2012.

Please return completed applications and letters of reference to:
Brady Svilich
Siskiyou Family YMCA
350 N. Foothill Drive
Yreka, CA 96097