Camp Green Lane: Staff Application

Camp Green Lane
1000 Germantown Pike, F-3
Plymouth Meeting, PA 19462
(P) 610-270-1700
(F) 610-270-1708

Please send a recent photo to the above address, or email a digital picture to melcgl@aol.com

Full Name:

Email:

Personal Web Site:

Home Address:

City:

State:

Zip Code:

Social Security #:

Date of Birth:

Home Phone #:

Age Now:

School Phone #:

Height:

Gender:

Weight:

Martial Status:

Have you ever been convicted of a crime or sexual offense?

Yes No

If yes, explain below:

By typing "Agree" in this box I hereby agree to a criminal background check

School Attending:

Year in School:

Major:

School Address:

City:

State:

ZIP Code:

Camp Experience - List most recent employment first.
If no experience, list employment history.

1. Camp Name:

Position Held:

Location:

Time Employed:

Director's Name:

Phone Number:

2. Camp Name:

Position Held:

Location:

Time Employed:

Director's Name:

Phone Number:

3. Camp Name:

Position Held:

Location:

Time Employed:

Director's Name:

Phone Number:

References

1. Name:

Phone Number:

Address:

Title:

2. Name:

Phone Number:

Address:

Title:

3. Name:

Phone Number:

Address:

Title:

How did you hear about us? (Choose One)

If friend or sibling - Who?

Type of position interested in:

Salary at last camp:

Lowest salary expected at Camp Green Lane:

Number of future summers available for camp work:

Indicate below the age level(s) that you are interested in working with:

Junior Division	6	7	8
Intermediate Division	9	10	11
Senior Division	12	13	14

Please select number one (1) next to those activities that you can organize and teach as an expert; write the number two (2) next to those activities you can assist in leading, and write number three (3) next to those activities which are just a hobby to you.

Waterfront	Sports	Other	Camp Craft
Adv Life Saving	Archery	Arts & Crafts	Cookouts
Boating	Badminton	Campfires	Fire Building
Canoeing	Basketball	Dancing	Hiking
Diving	Field Hockey	Dramatics	Nature Craft
Kayaking	Football	Fishing	Camping Out
Paddle Boats	Gaga	Ham Radio
Swimming	Games	Home Economics	News paper
Tubing	Golf	Mountain Biking	Layout
Water Skiing	Go Karts	Musical Instrument	Typing
Jet Skiing	Gymnastics	Photography	Writing
WSI Certification	Horseback Riding	Song Writing/Leading	Graphics
LGT Certification	Lacrosse	Skits and Stunts
	Newcombe	Story Telling
Ropes Course	Ping Pong	Videography
Climbing	Soccer
Repelling	Softball	Other:
Maintenance	Tennis	1.
Belay	Track & Field	2.
Certification	Ultimate Frisbee	3.
	Volleyball
	Wrestling

What is the single most important contribution you feel you can make to Camp Green Lane?

What do you perceive the responsibility of a counselor to be?

Why have you chosen to apply to Camp Green Lane specifically?

Summer Office (after June 10):

249 Camp Green Lane Road
Green Lane, PA 18054
215-234-8666

Winter Office:

1000 Germantown Pike, F-3
Plymouth Meeting, PA 19462
610-270-1700

Email: melcgl@aol.com