Support Staff Application
At any time during this application you can click “Save Draft” and the bottom of the page and your application will be saved. If you don’t have time to complete your application the first time, you can save it and come back within one week to complete it. We have already emailed you details on how to log back in to this form.
LOCATION
(Page 1 of 9)
You may select more than one location.
PERSONAL/CONTACT INFORMATION
(Page 2 of 9)
First
Last
(We prefer to use Skype in the interview process)
(feet/inches)
(lbs.)
List each child's information on a separate line.
COLLEGE/UNIVERSITY INFORMATION
(Page 3 of 9)
Please provide your college/university information below:
EDUCATION
(Page 4 of 9)
(YYYY)
HOBBIES/INTERESTS/ACTIVITIES/EXPERIENCE/REFERENCES
(Page 5 of 9)
Past Employment
Please list all paid and volunteer positions

Employer 1


(example:Feb-09 to Jan-10)

Employer 2


(example:Feb-09 to Jan-10)

Employer 3


(example:Feb-09 to Jan-10)
References
Please list up to three people (not relatives or family) who have knowledge of your character, experience, work habits, and ability.

Reference 1


Reference 2


Reference 3


POSITION(S) DESIRED AT CAMP
(Page 6 of 9)
Please enter one or more choicies for positions you want to be considered for (i.e. Cabin Counselor, Soccer Instructor, Craft Instructor)

First Choice


Min (1-5) Max
Min (1-5) Max

Second Choice


Min (1-5) Max
Min (1-5) Max
CONTRIBUTIONS/EXPERIENCES YOU WOULD BRING TO SHANE
(Page 7 of 9)
SKILLS INFORMATION
(Page 8 of 9)
Using the following ratings key, please rate your ability for the skills/activities listed below. NOTE: You need only rate the activities you are interested in.

Experience Instructing = Experience instructing, high skill level and ability to teach and run the activity by yourself.
Strong Skills = No experience instructing, but strong skills and confident to teach and run activity by yourself.
Certified/Experienced = Certified/Experience Instructing.
KITCHEN
ADDITIONAL KITCHEN INFORMATION
MAINTENANCE
MEDICAL
ADDITIONAL MEDICAL INFORMATION
HOUSEKEEPING
OFFICE
MISCELLANEOUS AND ADDITIONAL INFORMATION
(Page 9 of 9)
(Include the camp names and the years you attended)
(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.)
Approximate Employment Dates for 2019
Arizona: June 12 - July 28
California: June 12 - July 28
Florida: June 5 - July 21
Connecticut (NY Area): June 15 - August 17 (Specialists may need to arrive as early as June 5th. Head Staff and Group Leaders end date is August 20)
Wisconsin: June 11 - July 27

Typically you are required to work these dates to gain employment

Start Date:
End Date:
If you wish to upload a resume (.doc, .docx or .pdf) and/or a photo of yourself (.jpg, .jpeg or .png), please do so below.
.doc, .dox, .rtf and .pdf files only
By typing my full name below (Digital Signature), I indicate that I have read the “Background Sheet” and clearly understand and accept its contents. I also authorize investigation of all statements herein, including any checks of criminal records, and release the camp and others from liability in connection with same. I understand that untrue, misleading or omitted information herein by the applicant may result in dismissal, regardless of the time of discovery.
.gif, .jpg, .jpeg, .jpe and .png files only