Staff Application

You may fill Camp Winnebagoe Staff Application by completing the form below.

Surname:
Given Name:
Popularly Known As:
Present Age:
Date of Birth:	Month Day Year
Social Insurance Number:
Health Card Number:
Email:

Permanent Address
Street and No.:
City and Postal Code:
Province:
Telephone Number:
Present Address
Street and No.:
City and Postal Code:
Province:
Telephone Number:
Send mail to Present Address until:	Month Day Year

SCHOOLING

High School
Name of School:
Certificate or Degree:
Year of: Present Grade: Graduation: Month Day Year

Name of University or College:
Present occupation (if student state course and year):
Why do you want to go to camp?


For what position are you applying?	Jr. Counselor Cabin Counselor Acitivity Counselor State what activity
With what age group do you prefer working?:
Second preference:
What experience have you had in the type of work for which you are applying?


State briefly your ideas concerning the personal qualities necessary to be a Counselor


CAMPING EXPERIENCE

As a Camper (List most recent first)
Name of Camp:
Location:
What Years Attended?:

Name of Camp:
Location:
What Years Attended?:

Name of Camp:
Location:
What Years Attended?:

As a Staff Member (State in what capacity Junior Counselor, Cabin Counselor, Acitivity Counselor, etc)
Name of Camp:
Location:
What Years Attended?:
Position Held:

In the following list mark the level of qualification:
Aerobics:
Ceramics:
Art:
Dancing:
Baseball:
Campcraft:
Dramatics:
Camp Newsletter:
Musical Comedy:
Canoeing:
Play Directing:
Canoe Trips:
Exercise & Fitness:
Crafts:
Horseback riding:
Kayaking:
Music:
Outdoor Cooking:
Overnight Camping:
Photography & Video:
Riflery:
Sailing:
Soccer:
Volleyball:
Swimming:
Life Saving:
Tennis:
Water Skiing:
Warship Services:
Windsurfing:
Other:
Please state details on all activities that you marked "qualified to instruct":

Swimming Ability:	Non-swimmer 50 yards 100 yards 300 yards or better
Swimming or Life Saving Awards held:

Have you any disabilities which would prevent you from full participation in all Camp Activities?

Write a brief biographical sketch including specialized training in camping or experience and training in other fields that would be helpful in your job at Camp:


Would it be convenient for you to come to Toronto for an interview? If so, when? Month Day Year

Will you be available for three days of pre-camp training at Camp, the end of June? Yes No
Salary per season at last camp (if any)
Salary expected per season

REFERENCES
Give the names of three persons who know you and know what you can do. If you have been on the staff of another Camp please include the names of the Director and any other persons in a supervisory capacity that could give us information about you. Other names for references should be former employers, other people who have had an opportunity to observe you in a working situation or school principals and teachers, in that order.

Reference Name:
Relationship:
Street and No.:
City and Postal Code:
Province:
Telephone Number:
Email:

Reference Name:
Relationship:
Street and No.:
City and Postal Code:
Province:
Telephone Number:
Email:

Reference Name:
Relationship:
Street and No.:
City and Postal Code:
Province:
Telephone Number:
Email: