First Name

Last Name

Address

City

State

Zip Code

Phone Number

Email Address

Date of Birth ... Format: YYYY-MM-DD (eg: 2003-12-25 for Christmas day)

Age as of June 22, 2008

Gender Female Male No answer

Camp Ma-He-Tu is in a very hilly, wooded area with many rocky paths.  Counselors may find it necessary to walk up and down the hills several times each day.  In addition, the job entails continual contact with children of the ages of 7 – 15.  Do you have any impairment, physical or mental, which would interfere with your ability to perform the job for which you are applying?  Yes No No answer

If yes, please explain.

Please list you education experience/degree.

Have you ever attended Camp Ma-He-Tu as a camper or worked here as a staff member? Yes No No answer

If yes, please list the years you attended as a camper and or worked as a staff member.

If you have worked at Camp Ma-He-Tu, please tell us how many summers you worked as a staff member for at least a month or more.   Only numbers may be entered in this field

Have you ever worked at a camp other than Camp Ma-He-Tu before? Yes No No answer

If yes, please explain.

What position(s) would you like to hold at camp this summer?

Please explain why you would be a good choice for this position.  Please include any certifications, along with expiration dates, which qualify you for this position.

Do you have a drivers license? Yes No No answer

Are you a member of a church? If yes please provide the church's name and address.  We are always looking for camper recuiting opportunities.  If you would be willing to help us by presenting at your church please let us know.

Camp Ma-He-Tu offers a wide variety of activities.  Please choose from the following programs to lets us know where you would most like to work.  My first choice would be... Choose one of the following answers Please choose.. Arts and Crafts Drama Nature Waterfront Discovery/Life Skills Athletics Archery Low Ropes Camp Newspaper Small Craft Field Games Tennis General No answer

My second choice would be... Please choose.. Arts and Crafts Drama Nature Waterfront Discovery/Life Skills Athletics Archery Low Ropes Camp Newspaper Small Craft Field Games Tennis General No answer

My third choice would be... Please choose.. Arts and Crafts Drama Nature Waterfront Discovery/Life Skills Athletics Archery Low Ropes Camp Newspaper Small Craft Field Games Tennis General No answer

Are there any other areas of interest or skills you would like to teach or help to teach at camp?

*List Three References: including their Name, Relation to you, Address, and Phone Number. THIS IS A MANDATORY PART OF YOUR APPLICATION. APPLICATIONS MISSING THIS INFORMATION WILL NOT BE CONSIDERED.

If you were not a member of the Camp Ma-He-Tu 2008 staff please write a brief biographical sketch, including experiences or specialized training that may have a bearing on the position for which you are applying.  If you wish, you may email this seperately to jpaddack@mahetu.org

Have you ever had any criminal convictions for child abuse of sex-related crimes? Yes No No answer

If yes, please explain.

Will you be able to commit to coming to camp for the whole summer, June 28th - August 22nd? If not list your available dates and your reasons for missing any time. Please note that applicants who are available for the whole summer will be considered before those who can only come for part of the summer.  It is a good possibility that if you can not come to camp for the whole summer, you may not be selected for employment.