Summer Camp Staff Application

Application Information

Girl Scouts of Ohio’s Heartland Council is an equal opportunity employer. All applicants for employment will be considered without regard to race, religion, color, sex, age, national origin, citizenship, disability, marital status, or any other classifications protected by applicable law, nor are you required to supply information that would reveal such classifications. You are not required to supply information that would reveal your race, religion, color, sex, age, national origin, citizenship, disability, marital status, or any other classification protected by applicable law.

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1.Contact Information(Required.)

Name:

Current address:

City, state, and zip:

I will be at my current address until:

Permanent address:

City, state, and zip:

Primary phone:

Primary e-mail address:

2.The best way to contact me is by:

Phone

E-mail

Either one

4.Girl Scouts of Ohio's Heartland operates several types of camps. Please tell us the program where you'd prefer to work.(Required.)

Resident Camp (Camp Molly Lauman in Lucasville, OH - traditional overnight summer camp, most staff live on site while camp is in session)

Day Camp (Camp Ken-Jockety in Galloway, OH - staff are hourly and do not live on site, shifts may include days, evenings, and weekends)

High Adventure (various locations - staff serve as trip leaders and travel with campers to a different site each week)

Please tell us if you'd consider working at a site other than your first choice.

6.High School Education

Name of school:

Field of Study:

Graduation date:

7.College Education

Name of school:

Field of Study:

Graduation date:

8.Other Education

Name of school:

Field of Study:

Graduation date:

9.Current Certifications/Trainings

Please list the certifying organization and expiration date.

First Aid

CPR

Lifeguard

Water Safety Instructor

Canoe/Small Craft Instructor

Archery Instructor

Horseback Riding

Other

10.Relevant Previous Employment and Volunteer History

Company:

Address:

Phone Number:

Supervisor:

Dates with Company:

Job Duties:

11.Relevant Previous Employment and Volunteer History

Company:

Address:

Phone Number:

Supervisor:

Dates with Company:

Job Duties:

12.Relevant Previous Employment and Volunteer History

Company:

Address:

Phone Number:

Supervisor:

Dates with Company:

Job Duties:

13.Relevant Previous Employment and Volunteer History

Company:

Address:

Phone Number:

Supervisor:

Dates with Company:

Job Duties:

14.References: Please list three individuals, other than relatives or personal friends, who know of your qualifications and/or background experience. We recommend former employers, teachers, ministers, school counselors, Girl Scout leaders or other persons who can give an honest account of your abilities, work ethic, and personality.

References will be e-mailed an online form to fill out. Please make sure that the address that you give is correct.

If you do not have an e-mail address for a reference, it is your responsibility to give them a paper reference that can be submitted. You form which can be found on www.gsoh.org.

Reference 1(Required.)

Name:

Relationship:

Phone number:

E-mail address:

15.Reference 2(Required.)

Name:

Relationship:

Phone number:

E-mail address:

16.Reference 3(Required.)

Name:

Relationship:

Phone number:

E-mail address:

17.Please note: The State of Ohio requires a Criminal Background Check for all employees who work directly with children.

Have you ever been convicted or pled no contest or guilty to a crime (other than minor traffic violations)? (Required.)

Yes

If yes, please state offense, date and location (a conviction record will not necessarily be cause for disqualification).

18.Do you have a valid driver’s license?(Required.)

Yes

19.Have you had your driver’s license suspended or revoked in the last four years?(Required.)

Yes

If yes, give details.

20.Girl Scouts of Ohio’s Heartland requests the following information because of our dedication and commitment to the girls we serve. All youth-serving organizations must take reasonable precautions when hiring paid staff who works directly with children. This information is confidential.

I certify that I never have been convicted of, nor pled no contest or guilty to the following:
• Child abuse in violation of Ohio Revised Code Section 2919.22
• Endangering children in violation of section 2907.04
• Gross sexual imposition in violation of section 2907.05
• Sexual imposition in violation of section 2907.06
• Importuning in violation of section 2907.07
• Voyeurism in violation of section 2907.08
• Public indecency in violation of section 2907.09
• Any offense of violence or any existing or former offense of any municipal corporation, this state, any other state or the United States that is similar to any of the above offenses.

I agree with the above statements:

(Required.)

Yes

21.You don't have to have been a camper to be a great camp staff member, but we'd like to hear about your camp experience if you've got it.

Did you attend camp as a child?(Required.)

Yes

22.If you've attended camp, tell us how many summers you attended camp and what type(s) of camp you attended.

23. Have you participated in a Counselor in Training or Day Camp Program Aide program?

Other (please specify)

24.If you answered yes to the above question, please tell us when and at what camp. Also, please tell us about the most important thing that you gained from that experience.

34.Why do you want to work at camp this summer?(Required.)

35.How can camp change the world?(Required.)

36.What do you hope to gain by working for Girl Scouts of Ohio's Heartland this summer?(Required.)

37.How will camp be a better, safer, and more magical place for campers because you are there?(Required.)

38.Describe your experience with outdoor living, dealing with minimal personal time, and/or working with kids.(Required.)

39.Returning Staff Only: What have you done since last summer that will make you a better staff member this summer?

40.Returning Staff Only: Describe one good and one bad experience that stand out in your mind from your last summer of employment. What could you have done to make your bad experience better?

41.I certify that the information is true and complete and that I have not knowingly withheld any information which might, if disclosed, affect my application unfavorably. I understand that any misrepresentation or omission of facts on this application will be cause for rejection of this application or dismissal after employment.

I understand that employment is conditioned upon acceptable results of a pre-employment screening and successful completion of a background check as required by the State of Ohio. Additionally, I understand that I will be required to submit a certificate of physical examination upon arrival at camp.I am aware that I must become a member of Girl Scouts of the U.S.A. and I agree to uphold its ideals and policies.

I understand that this employment application and any other Girl Scout documents are not contracts of employment, and that any individual who is hired may voluntarily leave employment at any time, with or without cause or notice, and may be terminated by the council at any time with or without cause or notice. I understand that any oral or written statements to the contrary are hereby expressly disavowed and are not to be relied upon by any prospective or existing employee.

I authorize Girl Scouts of Ohio’s Heartland to inquire into my employment history and qualifications for the position(s) for which I am being considered. I authorize past/current employers and other persons to release the information requested by Girl Scouts of Ohio’s Heartland. I hereby waive any and all claims against any person who provides information in response to Girl Scouts of Ohio’s Heartland’s request concerning my employment history and other qualifications.

I HAVE READ, UNDERSTAND, AND CONSENT TO THESE STATEMENTS.

(Required.)

I agree

I do not agree

Summer Camp Staff Application - 2013

Application Information