Camp Lohikan's

Online Supervisory Staff Application

Please note that supervisory staff applicants must have completed at least 4 years of college and typically include certified teachers, coaches and other child care professionals.

* Required Information

Section 1. General Information


Name:	*
Email:	*

Address at School: (if applicable)		Street:	State:
		Town:	Zip:
		County:
		Country:
		Phone:

Permanent Address:	Street:	State:
	Town:	Zip:
	County:
	Country:
	Phone:

Best time to reach you:

Date of birth:

Month/Day/Year

Gender:

Age by July:

Married?

No. of Kids:

Are your kids coming with you?

		Age	Sex		Age	Sex
	Child 1:			Child 4:
Age & Sex of Children:	Child 2:			Child 5:
	Child 3:			Child 6:

Is your spouse interested in working at camp? If yes, please indicate what your spouse would like to do at camp:

Do you have a valid driver's license?

If yes, what is the state and license No.:

If yes, describe your experience:

Can you drive a 15 passenger van?

If yes, describe your experience:

Will you have a vehicle in camp this summer?

If yes, what type of vehicle will you bring?

Do you have a valid CDL driver's license?

If yes, please indicate the type and whether you have passenger endorsement.

If yes, what is the state and license No. for the CDL:

If yes, describe your CDL experience:

How did you learn about Camp Lohikan?	Search Engine:
	Web Directory:
	Other Source:

If you learned about Camp Lohikan though a former Staff Member, please indicate his/her name here:

Earliest starting date available:

Latest ending date available:

Do you have any dietary restrictions? If yes, please explain:

Do you smoke?

Can you swim?

Are you currently taking any RX drugs for a medical condition or recurring disease?

Do you have any condition that might limit your ability to watch over children at camp? If yes, please explain.

Please check all certifications/licenses held by you.

Please indicate any other certifications you hold that might have bearing upon your camp employment.

Do you play a musical instrument?
If yes, which one?
Can you transpose music?

Minimum Salary Expected:

(Please keep in mind that room, board & laundry services are provided and our camp season covers 50 work days and a one week orientation. Our summer staff members are also invited to attend our Camp Ski Reunion.

Section 2. Program Skill Areas:

The following is a list of the activities offered at Camp Lohikan. Please check all the areas that you would feel comfortable leading and teaching.

While many of our supervisory positions are Head Instructor positions, we do have a number of Non-Activity Supervisory positions available. If you are interested in one of these non-program positions, please check the appropriate box located in the Other Section.

Camp Support

Which activities are you most qualified to teach? Please describe your personal experiences, qualifications, proficiencies, awards won and certifications earned in those areas.

What is your First Choice?

What is your Second Choice?

What is your Third Choice?

Is there anything else you'd like to do?

What is your experience in working with children, ages 6 through 15?

What do you think are the most important aspects to being an excellent staff member?

What contributions do you think you can make to camp and to the children?

What characteristics do you feel you possess which will make you an effective supervisory staff member?

Section 3. Education:

College	Major	Years as of June	Degrees Granted

Section 4. Character References:

Please list names and telephone numbers of 3 people (Not Relatives!) who have knowledge of your abilities, experience and character.

Reference 1
Name:		Daytime Phone:
Address:		Evening Phone:
City:		Relationship:
State:
Zip Code:

Reference 2
Name:		Daytime Phone:
Address:		Evening Phone:
City:		Relationship:
State:
Zip Code:

Reference 3
Name:		Daytime Phone:
Address:		Evening Phone:
City:		Relationship:
State:
Zip Code:

Section 5. Previous Camp Employment:

Camp Director Reference 1:

Name:		Camp Name:
Address:		Job Held:
City:		Phone:
State:		Start Date:
Zip Code:		End Date:

Camp Director Reference 2:

Name:		Camp Name:
Address:		Job Held:
City:		Phone:
State:		Start Date:
Zip Code:		End Date:

Camp Director Reference 3:

Name:		Camp Name:
Address:		Job Held:
City:		Phone:
State:		Start Date:
Zip Code:		End Date:

Section 6. Other Past Employment: If you have not worked at a camp before, please list your employment for the past 3 summers or years.

Dates (Begin & End Dates)	Employer & Phone No.	City	State	Nature of Work

Have you ever been convicted of child abuse or a sexual abuse offense?

Have you ever been accused or convicted of a felony or misdemeanor? If yes, please explain:

The statements made in this application are true, complete and correct. I understand that any misrepresentation of information shall be considered sufficient reason for withdrawal of an application with Camp Lohikan.

I hereby authorize Camp Lohikan or its authorized representatives bearing this release or copy thereof to obtain any information pertaining to my employment, military, credit, criminal, driving record, workers compensation claims, or educational records, including but not limited to information concerning academic achievement, attendance, disciplinary actions, criminal or civil court records, credit and driving history, character, work habits, performance, experience and reasons for termination of past employment. I hereby direct you to release such information at the request of Lohikan or its representatives.

By electronic submission of this application to Camp Lohikan, I understand and agree to the conditions set forth above.