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Returning Staff Application
First Name (*)

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Last Name (*)

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Camp Name (*)

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Current Address (*)

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City (*)

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State (*)

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Zip Code

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Phone (*)

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Cell Phone (*)

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Permanent Address (*)

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City (*)

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State (*)

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Email Address (*)

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Alternate Email

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Are You lawfully authorized to work in the United States? (*)



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Do you hold a current driver's license? (*)



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Will you be at least 18 years of age by June 1, 2013? (*)



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Certifications



Do you hold any certifications? For example, CPR by Red Cross.

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Do you know of any reason why you would not be able to perform the essential functions of the job position for which you are applying with or without reasonable accommodations? (*)



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If yes, please describe.

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Have you ever been convicted of a crime? (*)



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If yes, please describe.

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Date of conviction and location

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Choose first choice for position (*)

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Choose second choice for position

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Choose third choice for position

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What age group are you interested in working with? (Check all that apply.) (*)







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Select the weeks you are available to work. (Check all that apply) (*)







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Please list all weeks that you are available that have not been chosen above because you were not able to commit to a block of weeks.

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For Staff Members 16 yrs & older: Would you be able to work Thursday overnights? (*)





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If not able to, why?

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For Staff 18 and over: Would you be interested in working AM (6:45-8:30am) or PM (4-6pm) extended care? (*)







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I am interested in being a counselor for the following: (*)






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Please list any experiences related to the above programs.

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I am interested in being a couselor for the following: (*)










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Please list any experiences related to the above programs.

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I am interested in being a counselor for the following: (*)





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Please list any experiences related to the above programs.

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I am interested in being a counselor for the following: (*)




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Check off which open houses you will be attending: (recommended to attend at least one) (*)








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I agree to begin the hiring process by submitting this application with the understanding that if I am rehired I am expected to attend ALL of STAFF TRAINING. Choose ONE of the following weekends the hours for each will include Friday (6pm-10pm), Saturday (8am-5pm), & Sunday (11am-5pm): (*)



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List one thing you would like to learn about during Orientation. (*)

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Each staff member recieves 2 free staff logo t-shirts. Please select the size shirt you wish to recieve for this season. (*)

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The following are the staff sweatshirts which are available for purchase. The cost of each shirt is $25.00. These are the only sweatshirts which may be worn over camp shirts. All other sweatshirts may be worn but must be under the staff t-shirt. Please mail payment for these shirts in the form of a check to 242 Adelphia Rd., Farmingdale, NJ 07727 Attn: Joan Basilotto. The deadline to order and pay for sweatshirts is March 1st.

(*)

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PLEASE READ BEFORE SIGNING

We appreciate your interest in a position with the Girl Scouts of the Jersey Shore/Camp Sacajawea. If you have questions about signing the following statement, please ask the interviewer to explain.

STATEMENT OF APPLICANT

In an effort to attract the highest quality staff, I understand that as a part of the application process for employment with the Girl Scouts of the Jersey Shore, Inc. (GSJS), an extensive inquiry will be made concerning my prior employment, activities, character, and I fully consent to and authorize all such inquiries. In the event of my employment by GSJS, I will comply with all policies set forth in the personnel manual and with other policies established from time to time by the organization. I certify that all statements made by me on this application are true and complete to the best of my knowledge and that I have withheld nothing that would, if disclosed, affect this application unfavorable. I understand and agree that any misrepresentation or omission of facts would exclude my being considered for employment or, after employment, would be cause for termination of employment with GSJS. I understand that a background check will be processed. I hereby acknowledge that I have read and understand the above statements and that I voluntarily sign this application by checking the accept box below.

(*)

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I hereby acknowledge that I have read and understand the above statements and that I voluntarily sign the application. (*)

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