iCan Shine Summer Employment Application

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* 1. Name

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* 2. Date of birth

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* 3. Email address

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* 4. Current city and state of residence

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* 5. Program(s) of interest

iCan Bike-Floor Supervisor

iCan Bike-Bike Technician

iCan Swim Instructor

iCan Dance Instructor

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* 6. Do you have any experience working with children or individuals with disabilities? If so, please describe.

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* 7. What is the first date you are available to work at a summer camp full time beginning June 1st?

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* 8. What is the last date you are available to work at a summer camp full time? (With programs ending August 31st)

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* 9. Are there any days, between the above dates, you are unavailable to work?

Yes

If yes, please specify what dates

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* 10. There may be training opportunities for new staff in the spring. What dates between March 1st and May 31st are you available?

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* 11. Will you submit to drug and background testing?

Yes

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* 12. Do you have any convictions other than minor traffic violations?

Yes

if yes, please specify

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* 13. Do you have a valid drivers license?

Yes

If yes, in what state?

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* 14. Do you have any restrictions on your drivers license?

Yes

If yes, please specify

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* 15. Do you have any driving convictions for the last 3 years?

Yes

If yes, please specify

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* 16. Canada has tightened the requirements for admission by US Citizens as of late. For example, convictions that are misdemeaners in the US (like DUI) are considered as felonies by Canadian authorities. Do you have any reason to expect that the Canadian government would deny you entrance to Canada?

Yes

If yes, please specify

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* 17. Do you currently have a valid US or equivalent passport?

Yes

If no, do you anticipate having one by June 1st

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* 18. Are you able to be on your feet for 9 hours a day with minimal breaks?

Yes

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* 19. Describe your regular fitness routine and physical activity level

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* 20. Are you CPR certified?

Yes

Expiration date

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* 21. Are you First Aid certified?

Yes

Expiration date

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* 22. Do you hold any other Red Cross or similar certifications? (Please indicate certification and expiration date.)

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* 23. This position requires travel. Do you have any reasons that would preclude travel?

Yes

If yes, please explain

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* 24. Are you able to be away from home for extended periods (six to eight weeks)?

Yes

If no, please explain

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* 25. Are you willing to share housing accommodations with a person of the same gender if necessary?

Yes

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* 1. Name

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* 2. Date of birth

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* 3. Email address

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* 4. Current city and state of residence

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* 5. Program(s) of interest

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* 6. Do you have any experience working with children or individuals with disabilities? If so, please describe.

Question Title

* 7. What is the first date you are available to work at a summer camp full time beginning June 1st?

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* 8. What is the last date you are available to work at a summer camp full time? (With programs ending August 31st)

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* 9. Are there any days, between the above dates, you are unavailable to work?

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* 10. There may be training opportunities for new staff in the spring. What dates between March 1st and May 31st are you available?

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* 11. Will you submit to drug and background testing?

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* 12. Do you have any convictions other than minor traffic violations?

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* 13. Do you have a valid drivers license?

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* 14. Do you have any restrictions on your drivers license?

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* 15. Do you have any driving convictions for the last 3 years?

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* 17. Do you currently have a valid US or equivalent passport?

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* 18. Are you able to be on your feet for 9 hours a day with minimal breaks?

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* 19. Describe your regular fitness routine and physical activity level

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* 20. Are you CPR certified?

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* 21. Are you First Aid certified?

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* 22. Do you hold any other Red Cross or similar certifications? (Please indicate certification and expiration date.)

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* 23. This position requires travel. Do you have any reasons that would preclude travel?

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* 24. Are you able to be away from home for extended periods (six to eight weeks)?

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* 25. Are you willing to share housing accommodations with a person of the same gender if necessary?

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* 26. Additional Comments