STAFF APPLICATION Personal Info Birthday: Gender: MaleFemale Dates available to work this summer: All SessionsOlder Boys (June 17-28)Younger Boys (July 2-9)Older Girls (July 16-27)Younger Girls (July 31-August 7) Employment History List all previous work experiences, name of supervisor, and current phone number. Explain what kind of work you did and why you left the job. Job #1 Job #2 Job #3 Camp Experience Please indicate any previous camp experience you have had including day camps, church programs, or other non-traditional camp settings. Camp #1 Camp #2 Camp #3 Education High School and Beyond Alkulana's aim is to offer a Summer Camp experience for children who may not otherwise be able to afford a camp experience. Please write a brief biographical sketch explaining how you see yourself fitting into this mission. What does it mean to you? What kind of impact do you feel a well-run Christian camping experience can have on a child's life? What specific gifts and skills do you have that you think would make you good at this job? If given the opportunity, what are you most looking forward to about working at Camp Alkulana? Limitations Please indicate the condition of your health ExcellentGoodFairPoor Do you have any physical limitations which would affect your participation in an active adventure camp environment? YesNo Criminal History Have you ever been convicted of a crime, other than a minor traffic offense? If yes, please describe. (Note: a prior conviction is not an automatic bar to employment. The type of conviction and when it occurred will be evaluated by the camp before any decision is made.) YesNo Harrassment The camp's policy is to prohibit all forms of harassment. This includes sexual, racial, religious, and other forms of harassment. Have you ever been accused of harassment of any person including, but not limited to, workplace harassment? (Note: a prior conviction is not an automatic bar to employment. The type of conviction and when it occurred will be evaluated by the camp before any decision is made.) YesNo References Give names and addresses of three adults (not relatives) who have knowledge of your character, experience, work habits, and ability. At least one of these reference should have observed you at work with children and/or youth. Please let these individuals know that the Camp Director will be contacting them.