Camp Ramaquois - A Day Camp As Complete As A Sleepaway

* Denotes required field

Section 1 of 5: Personal Information

Position Applied For:
Recommended By:
Returning Staff Member?:

*First Name:
*Last Name:
Gender:
*Address:
*City:	*State:	*Zip:
*Home Phone:
Cell Phone:
Social Security #:
Email Address:

*Date of Birth:

If applicable, please list any of your children who you plan to have attend Camp Ramaquois this summer.
Child's Name	Gender	Grade (Sept. 2008)

Section 2 of 5: Educational Information

Name of Last School Attended:
Grade Completed By July, 2008:
School City/State/Zip:
Degree(s) Received:
Major/Concentration:

Section 3 of 5: Camp/Work Experience (Camper or Staff)

Please list any previous experiences you've had as a camper
Camp Name	City/State	Year(s) Attended

Please list any previous experiences you've had as a staff member
Camp Name	City/State	Year(s) Employed	Position Held

Please list your three most recent non-camp work experiences
Company	Dates Employed	Position Held	Reason for Leaving

Skills & Licenses

Please select up to 6 activities that you can teach, assist in teaching or are a hobby.

6. Other:

Please indicate licenses or certifications that you currently hold, and their expiration date

CPR

First Aid

LGT

RTE

WSI

Section 4 of 5: References

Please provide the names, phone numbers, and e-mail addresses (optional) of three (3) people who can attest to your work ethic, character and qualifications for working as a role model for children and a positive member of our team. References should be employers, teachers, guidance counselors, coaches, advisors, or people for whom you have babysat. Family members can not be references.

Name of Reference Relationship Phone Number E-Mail Address

Section 5 of 5: Other Important Information

Camp Session: Monday, June 30th - Thursday, August 21st, 2008
Do you have any conflicts with the above dates?
If yes, briefly explain:

Salary Desired:

Extracurricular Interests & Hobbies (Varsity, intra-murals, clubs, etc..):

Why do you think you would be an asset to Camp Ramaquois:

Please answer the following questions. If you answer "yes" to any of the questions, please explain in the space provided below:
*Camp Ramaquois is a nonsmoking environment. Do you smoke?
*Have you ever been convicted of a felony?
*Have you ever been placed on any registry for child abuse or sexual offense?
*Have you ever been convicted of driving under the influence of alcohol or a controlled substance?
*Do you have any physical restrictions which would interfere with your ability to perform the job for which you have applied?

If you answered "yes" to any questions above, or require any special accomodations to perform your duties, please explain:

*Are you currently negotiating or under contract with another camp?

Camp Ramaquois cannot guarantee transportation to camp for all staff.
*Do you require transportation?

ALL APPLICANTS MUST BE PREPARED
TO BE A BUS COUNSELOR IF NEEDED.

IMPORTANT: All applicants must fill out the following:
The two streets that border your home are:

and

The nearest main road is:

Select the ages you are best suited to work with.

First choice:
Second choice:
Third choice:

T-Shirt Size:

The statements in this application are true, complete and correct. I understand that any misrepresentation or omission of information shall be considered sufficient reason for withdrawal of an offer or subsequent termination of employment.

Please be advised that a criminal and identity background report will be obtained from an independent reporting agency for the purpose of evaluating each staff member for employment. Furthermore, each applicant will be checked through the state sexual offender and child abuse registries. Finally, because Camp Ramaquois is committed to hiring the best role models for our campers, please be aware that we may search social networking sites on the Internet (i.e. myspace.com, facebook.com) in order to better evaluate your character.

By electronic submission of this application to Camp Ramaquois, I understand and agree to the conditions stated above.

Please type the code shown in the image:

Click to send application in or to clear application.

phone: (845) 354-1600 • email: info@ramaquois.com

Camp Ramaquois is a day camp located in Rockland County, NY and serves boys and girls from Rockland, Bergen, Manhattan and Westchester counties.

Camp Ramaquois • Mountain Road P.O. Box D-1300 • Pomona, New York 10970