Summer Camp Job Application - Camp Mountain Chai in CA

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Camp Mountain Chai
Returning Staff Application

* required fields
*First Name:
*Last Name:
Position Applying For:
Are you over 18?	Yes No
If yes, what is your age?
Date of Birth:
Gender:	Male Female
* Email Address:
* Cell Phone Number:
PERMANENT ADDRESS
Street Address:
City:
State:
Zip Code:
Phone:
CURRENT ADDRESS
At this Address until:
Street Address:
City:
State:
Zip Code:
Phone:
CERTIFICATIONS (Please mail photocopies of all current certifications)
Driver's License #: State: Expiration Date: First Aid, C.P.R. or B.L.S. (Please indicate certifications and expiration dates): Waterfront (Please check and indicate expiration date): A.L.S. W.S.I. Other (specify)
MISCELLANEOUS INFORMATION Please take some time to reflect upon last summer and answer the following questions: I feel my greatest achievement from last summer was... The thing I have worked on to improve myself in the last year is... If I could change one thing about last summer it would be... The top three things (personally or professional) I would change about camp for this year are... This application is not a contract of employment. Please note that California is an at-will state. Have you ever been convicted of a crime? Yes No If yes, please mail a separate sheet giving full details. I certify that the above information is true and accurate to the best of my knowledge. I understand that if employed, it will become part of my personnel file and that any misstatement of fact or falsification may be cause for my immediate dismissal. I also acknowledge that Camp Mountain Chai programs provide a smoke-free environment and that smoking is not permitted on camp grounds. I also understand that application to work at Camp Mountain Chai indicates my ability to refrain from smoking during my time in camp. I also give Camp Mountain Chai my permission to run a criminal background check. Signature (type your name) Date: Please type the letters shown in the box below:

Camp Mountain Chai • 858-499-1330 • info@campmountainchai.com