Staff Application

* Name

* Social Security #

* Permanent Address

* Phone

Fax

* E-mail

Term Address

Phone

Fax

E-mail

EDUCATION

College

Major Subject

Present Status (check one) Freshman Sophomore Junior Senior Graduate
Year Degree Granted

WORK EXPERIENCE: List current and past two employers, dates, address, phone, type of work.

CAMP EXPERIENCE: List whether camper or staff, name of camp, director, address, and dates.

For the following, place a "1" before those activities which you can teach with skill as an expert, a "2" before those you can do or play well, and a "3" before those you can assist in teaching:

CRAFTS:

Other areas of expertise:

CREATIVE ARTS:

Dance
Dramatics
Music (Specify)
Piano Accompanist

LANDSPORTS:

WATERSPORTS:

Boardsailing
Canoeing
Diving
Kayaking
Sailing
Swimming
Water Skiing

CHALLENGE/TRIPS:

Backpacking
Campcraft
Hiking
Ropes Course
Canoe Trips

MISCELLANEOUS:

Computer
Typing

Other areas of expertise:

MEDICAL:

Nurse

HORSEBACK RIDING:

English Style

Which of the above activities would you like to teach?
1st Choice
2nd Choice

Dates available to work: From to

* REFERENCES: Please list three people who have knowledge of your character, work experience and ability, and who are not relatives or personal friends. Please give a reference form to each person you list, accompanied by a stamped envelope addressed to Camp Tapawingo, P.O. Box 248, Maplewood, NJ 07040.


* BIOGRAPHY: Write a brief biographical sketch, including specialized training in camping and experience or training in other fields which might have a bearing on the position(s) for which you are applying.

CERTIFICATIONS/LICENSE
I am currently certified or will be by June 1 (complete appropriate lines)

Certification cards/license documents will be requested at camp for purposes of copying and to have on file during the camp season.

TRIP APPLICANTS ONLY: List your experiences for Trips (backpacking-canoe)


* Do you Drive? yes no
License Number
State Click to select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

* Have you had any accidents or violations within the last 3 years? yes no
If yes, explain:

Where did you learn about Tapawingo?

* Have you ever been convicted of an offense involving a child or sexual abuse? yes no


I authorize investigation of all statements herein and release the camp and all others from liability in connection with same. I understand that, if employed, I will be an at-will employee and that any agreement to the contrary must be in writing and signed by the director of the camp. I also understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery by the camp.