Staff Application

If you would like to work at Black Bear Lake Day Camp, please fill out the application below. After filling out the application, you will be contacted by phone and/or email according to our staffing needs, to set up an interview.

We look forward to hearing from you!

Name*:
Gender:
Male Female
Address:
City:
State:
Zip:
Telephone*:
College Address:
(if you live at school)
City:
State:
Zip:
Telephone:
Year in School Sept. 2017
E-Mail Address*:
Cell Phone Number:
Will you be 18 years old or older as of June 26, 2017?
Yes
No
Have you graduated High School?
Yes
No
Year of graduation:

Educational Background

Dates Attended
School
Major
Degree
High School
Dates Attended
School
Major
Degree
College
Dates Attended
School
Major
Degree
Other
Dates Attended
School
Major
Degree

Past Employment
(LIST THREE MOST RECENT JOBS)

Dates of Employment
Company Name
Address/Phone
Responsibilities
Supervisor
Reason for Leaving
Dates of Employment
Company Name
Address/Phone
Responsibilities
Supervisor
Reason for Leaving
Dates of Employment
Company Name
Address/Phone
Responsibilities
Supervisor
Reason for Leaving
Dates of Employment
Company Name
Address/Phone
Responsibilities
Supervisor
Reason for Leaving

Camp Experience
(as Camper or Staff)

Dates of Employment
Camp Name
Address
Camper or Staff Position
Supervisor
Reason for Leaving
Dates of Employment
Camp Name
Address
Camper or Staff Position
Supervisor
Reason for Leaving
Dates of Employment
Camp Name
Address
Camper or Staff Position
Supervisor
Reason for Leaving
Dates of Employment
Camp Name
Address
Camper or Staff Position
Supervisor
Reason for Leaving

References
3 persons (not personal friends or relatives) having knowledge of your character, experience and ability.

Name
Address
Phone
Email
Relationship
Name
Address
Phone
Email
Relationship
Name
Address
Phone
Email
Relationship
Name
Address
Phone
Email
Relationship
How did you hear about Black Bear Lake?
What type of position do you want at camp?
The camp season is from June 26th thru August 18th, 2017. Are you available to work the entire 8 weeks?
Yes No
If no, explain:
List any sport teams played (including any varsity letters received)
Do you sing and play the guitar?
List any experience working with children in schools, clubs, volunteer work, baby-sitting, etc.
Do you hold any current certification, training, or experience in the following areas? (List date certified)
CPR
First Aid
Lifeguard
WSI
Mobile Medic

Place a check mark next to those activities you can organize, teach and have experience in.

SPORTS
Baseball / Softball
Soccer
Basketball
Gymnastics
Archery
Horseback Riding
Laser Tag
Roller Blading
Street Hockey
Tennis
Camping / Outdoor Living Skills
Rock Wall Climbing
Martial Arts
Yoga
PERFORMING ARTS
Acting
Dance
Guitar
FINE & APPLIED ARTS
Pottery
Wheel Throwing
Painting
Crafts
Jewelry Making
Cooking
Woodworking
Radio Station
Slot Cars
Model Making
Science Fun
Chess
Technology
LAKEFRONT & AQUATICS
Boating
Fishing
Lifeguarding
Swim Instruction
Additional questions or comments:

I authorize investigation of all statements herein and release and all others from liability in connection with the same. I also authorize BBL to conduct necessary background checks, including criminal investigations to determine my fitness for the position applied for. 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. In addition, I have never been the subject of an investigation relating to the physical or sexual abuse of another person.
Yes   No

ELECTRONIC SIGNATURE*
(Please type name)
DATE*
(Please type date)

All statements become part of any future employee personnel files. State Human Rights Law forbids discrimination on account of race, color, creed, sex, national origin or age.