Staff Application

 

Please Fill Out & Complete All Fields
Note: Use "TAB" Key and/or Pointer to Move Between Fields

Name:
Date of Birth (MM/DD/YY):
   
Address:
Town:
Zip Code:
   
Telephone #:
Cell Phone # :
Email:
   
Education  
Are you attending: High School College
School year as of September:
Major or intended major:
   
Camp Experience  
Please list any camp experience you have and any skills you can teach (example: Arts n Crafts, photo, music, drama, gymnastics, rock climbing, boating, nature, mountain biking, karate, etc...)
If you can teach swim, please list qualifications:
Age group prefered:
Have you ever been convicted of a felony or a misdemeanor? Yes No
Has you drivers license ever been suspended? Yes No
   
References Other Than Relatives  
Name:
Relationship:
Telephone#:
   
Name:
Relationship:
Telephone#:
   
Name:
Relationship:
Telephone#:
   
Additional Comments and/or Information:
   
*IF YOU HAVE NOT RECEIVED A REPLY VIA EMAIL WITHIN 24-48 HOURS OF SENDING THIS APPLICATION, PLEASE CALL US AT KENWAL 631.694.3399 THANK YOU!