Channel 3 Kids Camp - Where Community Builds Confidence

Please complete the following application or download printable version. The information will be sent to our Camp staff for processing.

Full Legal Name:

Age

Gender

Address:

City:

State:

Zip:

Permanent Address:
(if different from above)

City:

State:

Zip:

Home Phone:

Work Phone:

Phone during school year:

Please indicate best way to contact you the months of January through May

Best Contact:

Email Address:

Position desired at Channel 3 kids Camp

*(Program Staff: Arts and Crafts, Archery, Performing Arts, Nature, Recreation, Radio, Computers, Ropes)

List Previous Camp Experience including names of camps and Phone numbers (if none, please indicate)

Camp starts in the middle of June and goes through to the end of August. Do you have any conflicts with this time frame? If so, please explain

Education

High School - Name, Location, Course of Study, Degree or Diploma

College - Name, Location, Course of Study, Degree or Diploma

Graduate School - Name, Location, Course of Study, Degree or Diploma

Additional Education:

Work History
Please list your most recent employment first.

Work Reference - Company Information (list complete addresses, supervisor names and numbers, and reason for leaving)

2nd Work Reference - Company Information (list complete addresses, supervisor names and numbers, and reason for leaving)

Activity Profile
Please choose one of the options.

Outdoor Living Skills

Hiking:

Outdoor Cooking:

Tent Camping:

Ropes Course:

Other:

Swimming Wellness/Fitness/Aerobics

Life Guard:

WSI:

Creative Crafts

General Crafts:

Painting/Sketching:

Nature Crafts:

Instrument:

List Instruments:

Drama (shows and skits)

Dance:

Photography/Video:

List Other:

Environmental Education

Birds:

Wildlife:

Gardening:

Weather:

Nature Hikes:

Night Hikes:

Plants and Trees:

Recreation

Team Sports:

Archery:

Team Building Initiatives:

Other Skills

Newspaper/Journalism/Radio Broadcast:

Computer Skills:

Please list and explain experience/training that is relevant to the job for which you are applying (please remember to send in copies of relevant certifications).

Are there any restrictions that would prevent you from performing the essential functions of the job, with or without accommodation?

Restrictions:

Have you ever been convicted of any criminal offenses? If so, explain

Additional Comments:

By submitting this form, you are allowing Channel 3 Kids Camp to verify the information provided.