Personal Details

Name*

First Last

Nickname or preferred name

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone

Skype User Name

Date of birth

MM

DD

YYYY

Working With Us

Which position(s) interests you the most?*

Day Camp Educator
Residential Camp Counselor (CC)
Residential Program Educator and CC
Waterfront Director
Day Camp Counselor
Trip Leader
Leadership Instructor
Internship
Other

Specify other position*

Dates of availability*

For positions available at both locations, what is your preference?*

No preference
Tanglewood, Lincolnville
Blueberry Cove, Tenants Harbor

Education and Experience

List all of the high schools and colleges you have attended or are currently attending. Including courses of study and dates of graduation, or expected graduation.

Education history*

What experience do you have working with children?*

Employment/volunteer history*

List any related work or volunteer experience below. Include the position you held, name and address of the organization and dates of employment.

Three references*

Please list three people we may contact for references. Include contact details and their relationship to you. Examples of good referees might be employers, teachers or coaches. References should not be related to you.

Certifications

Please state the type of your most advanced certification and its expiration date.

Note: If accepted for a position you will need to provide copies of all relevant certifications.

CPR

First Aid

Lifeguard Training

Other

Driving license
WSI

List any additional certifications.

All About You

Why do you want to work at Tanglewood or Blueberry Cove?*

Did you attend champ as a child?*

Yes
No

If yes, where and when? What did you enjoy most about camp?

Which age group do you prefer to work with (select all that apply)?*

4-5
6-7
8-10
11-13
14-17

List your reason(s) for your choice(s) above*

What do you hope to gain from an employment related camp experience?*

What do you hope young people can gain from educational outdoor experiences?*

What personal interests, skills, knowledge or aspects of your character do you feel benefit our community?*

What qualities or characteristics do you feel you possess that will make you an effective counselor?*

Describe an experience where you worked well as part of a team.*

What do you think will be the greatest challenge for you in this position?*

Describe a significant experience you have had in the outdoors*

How did you spend your out of school hours as a kid during the school year and summers?*

Please fee free to add any additional comments which might help us to understand more about you and your qualifications.

Activities

Tanglewood and Blueberry Cove offer a great deal of flexibility in what activities are offered at camp — share your passions! If you're excited about an activity then it's likely campers will be too.

What activities do you feel that you could comfortably lead, or assist in leading (please indicate which) and what existing experience do you have with those activities?

Activities you could lead

Disclosure

Have you ever been convicted of any crime other than a minor traffic violation?*

Yes
No

If yes, please explain*

Is there anything that would interfere with your ability to perform the job-related functions for the job which you have applied?*

Yes
No

If there is, please explain*

If you are offered a position at Tanglewood and Blueberry Cove, we will conduct a criminal background check
Alcohol, drugs, tobacco, and tobacco products use are prohibited on campus, even if the employee is of the legal age to partake in these substances. Tobacco use is limited to personal time, off campus, and not in view of participants.

Statement of Purpose

I certify that my application and all attachments are true and complete to the best of my knowledge. I understand that any incorrect, incomplete, or false statements or information furnished by me may, at the discretion of the Tanglewood/Blueberry Cove 4-H Camps, disqualify me form employment, or cause my dismissal. I hereby authorize Tanglewood/Blueberry Cove 4-H Camps to make a thorough investigation of my past employment and activities. I release from liability Tanglewood/Blueberry Cove 4-H Camps, former employers, or any persons supplying such information. The language in this application is not intended to create, nor is it to be misconstrued to constitute, a contract of employment.*

Agree

Date*

4-H Camp & Learning Centers at Tanglewood & Blueberry Cove

Employment Application Form