Merrowvista Summer Staff Application 2012

General Information

Please tell us a little bit about yourself.

First Name *

Last Name *

Name I prefer being called

Email *

Social Security Number

Date I can start work: * mm/dd/yyyy

Date I must end work: * mm/dd/yyyy

Have you ever been a participant in an AYF camp or program? YesNo

Please describe:

Have you been employed by the American Youth Foundation: YesNo

Please describe:

Are you 18 years of age or older? * YesNo

Are you 21 years of age or older? * YesNo

T-Shirt size (unisex)

Driver's License Number:

State Issued:

Expiration Date:

Would family accompany you? YesNo

If yes, please include names of the family members and ages of the children?

Select the method which best explains how you found out about this job

Please specify:

Current or College Contact Information

Mailing Address

City

State

Province

ZIP Code

Telephone

Cell Phone

Until what date will you be at this address?

Permanent or Home Contact Information

Leave this section blank if you have only one address.

Street Address

City

State

ZIP Code

Telephone

Position(s) Sought

Select all the positions in which you are qualified and for which you have interest. You can read more about these positions and their requirements on our website .

Which Program Specialist position(s) are you interested in? Arts and CraftsAthleticsPerforming ArtsClimbing/ Adventure

Which Waterfront positions are you qualified to lead? SailingSwimmingWindsurfing

Please Specify:

Are you old enough for the position you have selected? yesno

If no, then please explain:

Education

High School

Name

Location

Diploma Received? YesNo

College/University

Name

Location

Major

Type of Degree

Please indicate your current academic year. If you are not in school, please select the last year completed.

Other Education

Name

Location

Training Received

References

Please list three references who can comment on your professional or academic work. One reference must be professional and one can be a character reference.

Reference

Name *

Organization/Position

Telephone

Email

Relationship *

Years Known (Rounded to the nearest year)

Reference

Name *

Organization/Position

Telephone

Email

Relationship *

Years Known (Rounded to the nearest year)

Reference

Name *

Organization/Position

Telephone

Email

Relationship *

Years Known (Rounded to the nearest year)

Certifications

Please indicate any current certifications you hold, including expiration date. CPR is required for all positions (a CPR course will be offered during staff training.) If you are not currently certified, please indicate the date in which you plan to take a course.

CPR Date your certification expires or date of a course you have signed up for.

CPR for Professional Rescuer Date your certification expires or date of a course you have signed up for.

First Aid Date your certification expires or date of a course you have signed up for.

Wilderness First Responder Date your certification expires or date of a course you have signed up for.

Wilderness First Aid Date your certification expires or date of a course you have signed up for.

Water Safety Instructor Date your certification expires or date of a course you have signed up for.

Lifeguard Date your certification expires or date of a course you have signed up for.

Wilderness EMT Date your certification expires or date of a course you have signed up for.

Archery Date your certification expires or date of a course you have signed up for.

White Water Canoe Name of White Water Canoe Course

Other-- Please Specify

Employment History

Please list previous employers OR provide this information on a current resume. List relevant experience first.

Resume

Optional- you may submit a current resume with your application, but it is not required.

You may paste your TEXT-ONLY resume here.

Or choose an attachment to upload: The file size limit is 4 MB.

Employer

Company Name

Company Address

Company Phone

From (Month/Year)

To (Month/Year)

Your Position

Supervisor's Name

Supervisor's Position

Your Duties

Reason for Leaving

Check this box if you DO NOT want us to contact this employer

Personal Insight Questions

Please respond to three of the following questions.

Describe your experience working with children or adolescents. You may cut and paste a response or type in this box.

Describe a time when you used sound judgment and leadership skills.

What Leadership qualities do you have that will make you effective in the position you seek?

At Merrowvista we live, work, and play in community. What do you see as the most necessary qualities to create a positive community experience for campers and staff?

Skills and Interest Survey

Please tell us a little about your experience in the following areas. You do not need previous experience to lead classes in an area. Please check boxes for all skills you could facilitate or assist with. *You do not need to fill out this section if you are applying for the Four Trails Program.

Please Specify:

Please give a brief narrative of your experience in the outdoors including any camping experience.

Please Specify:

Other Activities
Newspaper
Creative Writing
Foreign Language
Other

Please Specify:

Of all of the skills mentioned above, please list in order of priority those you would prefer to teach.

Four Trails Adventure Trip Leader Skills Survey

Please complete this section ONLY if you are applying for a position with the Four Trails Wilderness Adventure Program as a Trip Leader or Coordinator. You must be at least 21 years old for any of these positions.

Technical Resume

Please list the specifics of your most significant outdoor experiences. Elaborate on your personal expeditions, those in which you were guided or others were responsible for your welfare. Then list your experience as a guide, when you were responsible for yourself and other participants. Where applicable, we are interested in expeditions lasting seven days or more. This section is not meant to be intimidating, but rather serve as a guide to help us in assessing your technical experience. Feel free to attach additional information.

Paddling: flat water/white water, canoeing, kayaking, rafting. Please describe the route or area, your role, and the trip length.

Biking: touring, trail, multiple day/ overnight, supported/ unsupported. Please describe the route or area, your role, and the trip length.

Backpacking: mountain, desert, glacier, alpine. Please describe the route or area, your role, and the trip length.

Other: mountaineering, climbing, international trekking. Please describe the route or area, your role, and the trip length.

Additional Self-Assessment for Four Trails Candidates

Please answer the following questions with specific examples. You may paste a response into the boxes provided.

Please describe your experience facilitating groups and/or working with a team.

What experiences have you had where you have pushed yourself out of your comfort zone? What benefits and possible hazards did you experience in this risk-taking?

How would you apply the AYF specific outcomes of balanced living, best self and positive mobile communities on a Merrowvista wilderness trip?

What are your goals and expectations in working at Merrowvista this summer?

Employment Eligibility

Do you have the legal right to work in the USA? * YesNo

If you are not a U.S. Citizen, what type of visa do you have?

Have you ever been convicted of a crime ? * YesNo A conviction or court-martial is not necessarily a bar to employment. You may exclude minor traffic violations.

Please explain:

Have you ever been discharged or asked to resign by a previous employer? * YesNo

Please Explain

Personal Commitment

If selected for a leadership position with the American Youth Foundation, I will assume my responsibility conscientiously, give the camp and its directors my support and best effort, and at all times set the proper example for campers. I agree to abide by the American Youth Foundation’s policy prohibiting the use and possession of tobacco, alcohol and other illegal drugs on camp property. In addition, I will not be under the influence of such substances on camp property. Before commencing employment, I will provide verification of a clear criminal history, provide three written letters of reference, furnish a current physical examination and health history form, furnish legal documentation of my eligibility to work in the United States, and complete any necessary forms (i.e. tax withholding forms, I-9, etc) required for employment and participation with the AYF.

I have read and agree with these responsibilities. * Yes, I accept these responsibilities.No

Do you consent to a police record search? * Yes, I give my consent.No, I do not consent. State laws require a police record search on all adults working with children under the age of 18. Please indicate consent to such a search.

Please read carefully before submitting your application.

I hereby certify that my answers on this application are true and I understand that any information withheld or falsely provided by me in connection with the foregoing application may be grounds for rejection of my application or will subject me to immediate termination of employment. I understand this application is not an obligation to provide employment. The application will be kept active for 6 months and it must be renewed to be active for a longer period. I also recognize that my employment is based on receipt of satisfactory information from former employers or references. I hereby authorize the American Youth Foundation (AYF) without liability to contact prior employers (present employers, if authorized). I also authorize references given by me and authorize said employers or references to make full response to any inquiries by the AYF concerning this application for employment. Inasmuch as said information concerning my performance and conduct as an employee is furnished at my specific request and for my benefit, I hereby agree to hold harmless the AYF and all former employers and references listed on this application from any liability or claims of whatsoever nature. The employment relationship is by its nature a mutual one and I understand that just as I am free to terminate my employment at any time and at my option, with or without notice, AYF retains a similar right. I further certify that I have read the foregoing information and herewith knowingly make this authorization by setting forth my signature below.

I certify that I have read this information and I knowingly make this authorization by setting forth my signature below. *

THE AMERICAN YOUTH FOUNDATION IS AN EQUAL OPPORTUNITY EMPLOYER

Dedicated to a policy of non-discrimination in employment on any basis including race, color, sex, religion, national origin, age, sexual orientation, disability or veteran’s status, or any other class protected by law. This application remains current for 90 days. Re-application is required thereafter.

Applicants with disabilities may, consistent with the Americans With Disabilities Act, request accommodations needed to participate in the application process. Please contact the site specific office.

The American Youth Foundation's Camp Merrowvista www.ayf.com