BACKGROUND INFORMATION
First Name:
MI:
Last Name:
Present Phone #
Cell Phone (if different)
Present Address:
City:
State:
Zip:
Permanent Address:
City:
State:
Zip:
Permanent Phone:
I will be at my present address until:
Email Address:
Are you legally entitled to work in the U.S. ?
How did you find out about Camp Pepin?
EMERGENCY CONTACT
First Name:
Last Name:
Relationship:
Address:
City:
State:
Zip:
Home Phone:
Business Phone:
EDUCATION
High school grade completed:
College year completed:
STAFF POSITIONS
Please number in order of preference (1,2,3, etc.) the positions for which you would feel qualified and would like to apply. Leave blank all other positions.
SKILLS
Please indicate the skills that you could either teach (T), assist (A), or would like to learn (L) by circling the appropriate letter. Leave blank all other skills.
CERTIFICATIONS
Please indicate any certifications you currently possess (and their expiration dates, if applicable), or would be earning prior to employment. Leave blank all other certifications.
REFERENCES
Your application must be accompanied by three (3) reference forms, which may be submitted by postal mail or online through our website (www.camppepin.org/reference_form.htm). Please read over the information on the forms before distributing them. Each form should be completed and returned directly to YMCA Camp Pepin by the person making the reference. We recommend employers, teachers, ministers, coaches, or other persons who can give an honest character reference. References by personal friends or relatives will not be considered.
Please list the name, relationship, and phone number of the persons who will be providing your references.
It is important that your references be submitted as soon as possible. YOUR APPLICATION CANNOT BE CONSIDERED UNTIL ALL THREE REFERENCES ARE RECEIVED.
QUESTIONS
To help us get to know you better, please answer the questions below. An additional sheet may be used to answer any of the questions, if desired.
Why are you interested in camp work?
What strengths do you feel you would be able to contribute to our program?
What are some of the reasons you think parents send their children to camp?
What life skills do you believe children and staff can learn in a camp setting?
Have you ever been convicted of a felony, misdemeanor, child abuse, or sexual abuse offence?
If yes, please indicate the conviction(s), dates, and circumstances.
WORK EXPERIENCE
Please list previous employers beginning with the most recent.
Employer/Company
Supervisor
Address
Telephone
Your Position
Dates Employed
to
Reason for Leaving
Employer/Company
Supervisor
Address
Telephone
Your Position
Dates Employed
to
Reason for Leaving
Employer/Company
Supervisor
Address
Telephone
Your Position
Dates Employed
to
Reason for Leaving
I certify that the information provided in this application for employment is true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. I also understand that employment with the Red Wing Family YMCA is subject to passing a criminal background check and child abuse screening; therefore, I authorize the YMCA to conduct a police record check and child abuse screening, and to make any investigation of my prior educational and work history. I furthermore understand that if I am hired, my specific responsibilities, as set forth in my job description, will be subject to periodic evaluation by my supervisor(s), and the length of my employment is not guaranteed. Recognizing that I will be free to voluntarily terminate my employment with the YMCA at any time with or without cause, I acknowledge that the YMCA is an at-will employer and is free to terminate my employment at any time with or without cause.
I Agree with the statement above.
The Red Wing Family YMCA is an equal opportunity employer. |
