2025 Camp Counselor Application Please enable JavaScript in your browser to complete this form.Applicant Name *FirstLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeLayoutPhone *Highest Grade Completed *High SchoolCollegePosition Applying For *Counselor (Minimum Age 18, High School Graduate)Junior Counselor (Age 16/Age 15 w/Work PermitCamp Preference *Little Cubs (Age 3 - K)Adventure Camp (Grades 1 - 6)Teen Extreme (Grades 7 & 8, Tuesday - Thursday Only)Floater/One-on-OneAdventure Camp PreferenceGrades 1 & 2Grades 3 & 4Grades 5 & 6Please provide two personal references other than ones from relatives or your recommendation letter that would attest to your strength of character, attitude, integrity, and personality. Reference One (Name & Relation to You)Contact Phone & EmailReference Two (Name & Relation to You) Contact Phone & EmailUpload any copies of certifications your currently hold ie. CPR & First Aid Click or drag a file to this area to upload. Applicant Requirements - Conviction of a crime is not an automatic bar to employment by Community Services. Any falsification or misleading information on this application shall be grounds to refuse to employ or, having been employed shall be immediate cause for dismissal/discharge. Have you ever been disciplined, discharged, or asked to resign from a prion position? If yes, please explain below. *YesNoHave you ever been charged with, pleaded guilty, or "no contest" to, or been convicted of any crime involving sexual abuse of any person, or any other crime of moral turpitude? *Yes NoHave you (a) ever been convicted of a crime, other than a minor traffic offense; or (b) entered a plea of guilty or a plea of "no contest", or has any court ever deferred further proceedings without entering a finding of guilty and place you on probation? *YesNoIf you answered "yes" to any of the questions above, please explain, in detail, including the date of the court action, the offense in question, and the address of the court involved. Are you able to perform the tasks of the job for which you are applying, with or without accommodations? *YesNoIf an accommoation would be required to enable you to perform the job tasks, please describe that accommodation and how it would enable you to perform the job tasks.Email *School Name/Graduation Year *Available to Work Additional HoursBefore Care (7:00 - 8:15 am)After Care (3:00 - 5:30 pm)Activities You Would Be Interested in LeadingArts & CraftsGymnasticsTennis Dance/DramaRecommendation Letter (First Time Applicants Only) Click or drag a file to this area to upload. Please list employment experience (those relevant to the position first). Boss/Supervisor Employment Dates Contact Phone & EmailBoss/Supervisor Employment DatesContact Hone & EmailMy signature below constitutes authorization to check my employment history, including without limitation, criminal arrest and conviction record checks, reference checks, and release of investigatory information possessed by any state, local, or federal agency. I further authorize those persons, agencies, or entities that Community Services contact in connection with my employment application to fully provide Community Services with any information on the matters set forth above. I expressly waive in connection with any request for or provision of such information, any claims, including without limitation, defamation, emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have Community Services, its agents and officials, or against any provider of such information. Signature & Date *Office Use Only W-4 Federal W-4 MaineI-9Emergency Contact Info FormCPR & First Aid Work Permit Submit