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?
