Return Application | Athens Y Camps

Information

Returning Staff Application

Camp applying for: Boys Camp Girls Camp

First Name

Middle Name

Last Name

Name You Go By

Social Security Number

Drivers License Number

Date of Birth (mm/dd/yyyy)

Home Address

Home City

Home State/Province

Home Zip/Postal Code

Country

Temp/School Address

Temp/School City

Temp/School State/Province

Temp/School Zip/Postal Code

Email

Home Phone

Cell Phone

What position are you applying?

Dates available to work:

Certifications

Please check current certifications. CPR First Aid Lifeguarding WSI

RN/MD

Personal Information

What activites/classes are you interested in teaching and why? (Please list any experience or instruction you have in this area.

With what age group do you prefer to work? 7-8 9-10 11-12 13-14 15-16

Why do you prefer to work with this age group?

How many years have you been a staff member at either camp?

What do you feel has been your greatest contribution as a staff member?

Most Recent Education (High School and Above) Years / School / Degree or Diploma Granted

School

What are your reasons for wanting to return?

Having been a staff member, what will be a goal for your campers this summer?

In again seeking a postion on the staff, what obligations do you feel are most improtant to the administration?

The Athens Y Camps staff strive to be positive Christian role models to all the children that pass through its gates. As a staff member, what do you see as your role in helping to accomolish this goal?

As a former staff member, you should understand Athen Y Camp's policy regarding the use of illegal drugs in any form, alcohol and tobacco and the necessity of maintaining good personal habits of hygeine, grooming and conduct. Please elaborate on your understanding of and ability to adhere to these expectations.

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 or accusation and when it occured will be evaluated by the camp before a decision is made.) Y N

If yes, please explain.

Electronic Signature

I authorize investigation of all statements herein, including checks of criminal records, and release the camp and all others from liability in connection with the same. I understand that, if employed, I will be an at-will employee unless there is an agreement or law that alters that status. Furthermore, I understand that any agreement must be in writing and signed by the designated camp official. I also understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery by the Athens Y Camps. In applying for a camp position, the information, which I have furnished, on this form is subject to verification which may include a criminal history check and request from any Central Registry of child abusers. I understand that, as a condition of employment, I may be required to submit to a drug screen. I understand that refusal to submit to the drug screen or failure to qualify according to the minimum standards established by the Athens YMCA for the screen, may disqualify me from further consideration for employment.I understand that, if employed, I will be an at-will employee unless there is an agreement or law that alters that status. Furthermore, I understand that any agreement must be in writing and signed by the designated camp official. I also understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery by the Athens Y Camps.

By typing my name in full below I agree that all statements herein are true.

Your Name in Full:

Date:mm/dd/yyyy

Minor's Parent/Guardian Name in Full :

Date:mm/dd/yyyy