Summer 2008 Employment Application


 complete application in entirety
 complete sections I,III,IV,V and VI
 complete sections I,II,IV, and VI
(please check the appropriate box and complete the designated sections)

Section I
Last Name:
 First Name:
 M.I.:
 SSN#:
 Date:
Permanent Address(Street):
 City:
 State:
 Zip Code:
 Telephone:
Temporary Address (Street):
 City:
 State:
 Zip Code:
 Telephone:
E-mail Address:
 *NYS Health Laws require counselors to be age 17+ to supervise campers. Therefore, counselor candidates must be 17 before June 29, 2008. To be considered for senior counselor position, candidate must be age 19+ or age 18 and one year of college.
What position(s) are you applying for? (Minimum Age)














(see above *)


(see above *)


(see above *)


(age 17)


(see above *)


(age 18)

(age 16)

(age 19)
2008 camp season runs 6/22-8/22. CSM first offers positions to those individuals who are able to commit to the entire summer. If you are unable to commit to the entire summer, please indicate any time-off you will need this summer (list dates needed off):
ACTIVE Certifications (must be VALID THROUGH AUGUST 29, 2008)
  Expiration Date Certifying Organization
(American Red Cross, American Heart Assoc. etc.)
Water Safety Instructor (WSI)
Lifeguard Training for Beach & SFA
Emergency Medical Technician
Certified First Responder
CPR for the Professional Rescuer
Respond to Emergencies
NYS Public Vessel: Joint Pilot and Engineer
Small Boat Sailing Level 1 Instructor
Adventure Ropes Course - High Elements
Adventure Ropes Course - Low Elements
Education: High School Mo/Year Earned
College
Degree Earned Mo/Yr Earned
Major/Minor
College
Degree Earned Mo/Year Earned
Major/Minor
Additional Course Work/Seminars/Workshops
Previous Employment (List employers, in order, starting with most current employer.)
Employer Address
Phone Job Title
Date From To Final Wage $ Per
Describe Work Performed
Reason for Leaving/Wanting to Leave
 
Employer Address
Phone Job Title
Date From To Final Wage $ Per
Describe Work Performed
Reason for Leaving/Wanting to Leave
Are there employment experiences you have not listed?

Section II

Below, select "1" for those activities you feel you can expertly organize/teach. Please note that these activities/programs may only utilize one instructor. Select "2" for those you would be comfortable to assistant teach. Leave blank for those you have no interest.
Adventure and the Outdoors
High Ropes
Knot Tying
Belaying
Bouldering
New/Initiative Games
Plant Orientation/Nature
Outdoor Living Skills
Orienteering
Overnight Camping
Hiking 		The Arts
Jewelry Making
Pottery
Drawing/Sketching
Painting
Arts and Crafts
Fine Arts
Improv/Drama
Singing
Instruments
 Ballfield
Volleyball
Ultimate Frisbee
Archery
Basketball
Cheer Dance
Lacrosse
Flag Football
Soccer
Tennis
Golf
Dodgeball
Spiritual
Shared Prayer
Prayer Service
Liturgy Planning
Night Prayers 		General Program
Campfire Program
Evening Program
Rainy Day Program
Special Events/Parties
 Waterfront
Sailing
Kayaking
Water Skiing
Knee Boarding
Wakeboarding
Tubing
Swimming
Fishing
Canoeing
List diocesan and parish retreasts you have attended or staffed (indicate position held and date(s)).

Section III

References: You must provide three references - former employer, school official, advisor or coach. Do not include relatives or CSM employees.
After submitting the application, you can download the appropriate reference forms from the confirmation email. Photocopy and have those listed below fill out and return to the Camp Director.
Name


 Business/Address(complete)


 Position
How did you hear about employment opportunities at CSM?

(name)
(name)
(name)

()
Did you complete the CSM LIT Program?    CSM CIT Program?

Secion IV

Briefly explain why you want to become a staff member at CSM. Include contributions you feel you can make to Camp's program.

Section V

In the space provided below, describe your interest and experience that you believe qualifies you for a Camp position. Include school and church activities, hobbies, camp experience as a camper/leader, leadership training, social clubs, teaching/coaching experience. also include experience in areas such as: Red Cross Swim, Sailing, Water Skiing, Kayaking, Motor Boat Operating, Archery, Soccer, Pottery, etc. Please include Camp Stella Maris experience. You are welcome to submit a resume.

Section VI


Have you ever been convicted of any violation of law other than a minor traffic offense?, If yes, please give type of offense, name and location of court and date. Note: A conviction does not automatically disqualify you from consideration. The nature of the offense, date of conviction, work and educational history will be considered.

The information provided in this application for employment is true, correct and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. All offers of employment with CSM are contingent upon the candidate passing a background check. (After submitting the application, you can download the necessary form from the confirmation email.)

Name of Applicant: Date:
Name of Parent (if under 18): Date:
(appropriate signatures will be obatined during the hiring process)