Camp Wayne Girls

Incomplete or Overly Brief Applications Will Not Be Considered

Personal Information

Photo of Yourself:
First Name:
Last Name:
Age:
Gender:		Male Female
Date of Birth:
Email:
How did you hear about Camp Wayne?
School / Business Address:
Business / School Phone:
Home Phone:
Cell Phone:
Best Number to Reach You:
Best Time to Reach You:
Parents / Home Address:
Earliest starting date available:
Latest ending date available:
Camp Dates are June 19th - August 15th, 2010

Education
College	Major	Years completed as of next June	Degree granted

Activities

Describe what activities you would like to teach and explain your background and experience in each:

On the following list, click numeral "1" before activities you are highly skilled in and think you can teach to children, "2" for activities you are skilled in and have experience as a participant, and "3" for other areas you have interest working in. Select N/A if you have no interest in the activity.

LAND SPORTS		WATER SPORTS
Archery	N/A 1 2 3	Canoeing	N/A 1 2 3
Basketball	N/A 1 2 3	Diving	N/A 1 2 3
Field Hockey	N/A 1 2 3	Sailing	N/A 1 2 3
Golf	N/A 1 2 3	Swimming	N/A 1 2 3
Gymnastics	N/A 1 2 3	Waterskiing	N/A 1 2 3
Lacrosse	N/A 1 2 3	Slalom	N/A 1 2 3
Soccer	N/A 1 2 3	Wake Boarding	N/A 1 2 3
Softball	N/A 1 2 3	Yrs. Driving Boat
Tennis	N/A 1 2 3	CAMPING & NATURE
Track	N/A 1 2 3	Animal Care	N/A 1 2 3
Volleyball	N/A 1 2 3	Astronomy	N/A 1 2 3
		Backpacking	N/A 1 2 3
FINE ARTS & CRAFTS		Campfire Programs	N/A 1 2 3
Batik	N/A 1 2 3	Environmental Ed.	N/A 1 2 3
Calligraphy	N/A 1 2 3	Fishing	N/A 1 2 3
Ceramics (Hand Bldg)	N/A 1 2 3	Gardening	N/A 1 2 3
Ceramics (Wheel)	N/A 1 2 3	High Ropes Course	N/A 1 2 3
Drawing	N/A 1 2 3	Low Ropes Course	N/A 1 2 3
Jewelry	N/A 1 2 3	Overnight Camping	N/A 1 2 3
Linoleum Cuts	N/A 1 2 3	Nature Crafts	N/A 1 2 3
Macrame	N/A 1 2 3
Painting	N/A 1 2 3	MISCELLANEOUS
Photography	N/A 1 2 3	Aerobics	N/A 1 2 3
Sculpture	N/A 1 2 3	Fitness	N/A 1 2 3
Silkscreen	N/A 1 2 3	Camp Newspaper	N/A 1 2 3
Tie Dye	N/A 1 2 3	Cooking	N/A 1 2 3
Videography	N/A 1 2 3	Driver (21+)/ CDL License Administrative Assistant	N/A 1 2 3
Other Please specify:		Food Prep / Salads	N/A 1 2 3
		Gardener/Maintenance	N/A 1 2 3
MUSIC		Group Leader (20+)	N/A 1 2 3
Guitar Yrs.		Kitchen Worker	N/A 1 2 3
Piano Yrs.		Nanny	N/A 1 2 3
		New Games	N/A 1 2 3
DRAMATICS		Night Watchman	N/A 1 2 3
Choreography	N/A 1 2 3	Nurse - R.N.	N/A 1 2 3
Costuming	N/A 1 2 3	Nurses Aide	N/A 1 2 3
Creative Drama	N/A 1 2 3	Housekeeping	N/A 1 2 3
Directing	N/A 1 2 3	Self Defense	N/A 1 2 3
Lighting	N/A 1 2 3
Set Building	N/A 1 2 3	OFFICE
Sound System	N/A 1 2 3	Bookkeeping	N/A 1 2 3
		Computers	N/A 1 2 3
CHEERLEADING & DANCE		Typing	N/A 1 2 3
Cheerleading	N/A 1 2 3
Choreography	N/A 1 2 3
Dance	N/A 1 2 3
Stunting	N/A 1 2 3
Hip Hop	N/A 1 2 3

Previous Camp Experience as Camper or Staff (not required for Placement)
Camp	Camper/Staff	Director	States	Dates




Desired Salary:

Certifications (Please list all that apply)

CERTIFICATIONS

EXPIRATION DATE

CERTIFICATIONS

EXPIRATION DATE

Lifeguard Training (LGT)

Small Crafts:

Water Safety Instructor (WSI)

Other

CPR

Describe Work Experience with Children:

Why do you want to be part of Camp Wayne Family, and what qualities do you think make
you a good candidate?

Additional / Personal Comments: