Camp Discovery 2008 Volunteer Staff Application

Submission Deadline: April 9, 2008

Personal information

Full Name:
Other names by which known (i.e. maiden name):
Gender:
Date of Birth: (mm/dd/yyyy)
Home Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Work Phone:
Email:
Do you have a skin condition?

Work / School

Current Employer or School:
Business Address:
City:
State:
Zip:
Phone:
Type of Work:

Camp you are applying for:
Please note that volunteers for the Minnesota camps arrive for orientation one day before camp starts.

Position you are volunteering for:








Tell us about your medical training:

List most recent work experience

Year(s):
Location:
Experience:

Additional Information

Please describe your abilities and motivations that you believe will make you a valued member of the volunteer staff at Camp Discovery.
Do you have any experience in supervising and working with young children? Explain.
Do you have any particular skills, training or expertise that could be incorporated into a camp activity?
What expectations do you have for your time at camp and what would you like to get out of the week?

References

Please list three adult references that are not direct family members or friends. Appropriate references are teachers, supervisors, employers, or other authority figures that can attest to your degree of maturity and responsibility and your ability to work as a team player.
Reference 1
Name:
Address:
City:
State:
Zip:
Relationship:
Phone Number:
Reference 2
Name:
Address:
City:
State:
Zip:
Relationship:
Phone Number:
Reference 3
Name:
Address:
City:
State:
Zip:
Relationship:
Phone Number:

Letter of Reference

Please attach one letter of reference below, or send the letter to Janine Mueller:
Address:
Janine Mueller
American Academy of Dermatology
930 E Woodfield Rd
Schaumburg, IL 60173 		Fax:
(847) 330-8907
Attach letter:

Disclosure

Do you use illegal drugs?

Have you ever been convicted of a criminal offense?

Have you ever been charged with child abuse or neglect?

Has your driver's license ever been suspended or revoked?

Is there any other circumstance involving you or your background that would call into question your being entrusted with the supervision, guidance, and care of young people?

Conditions

  • I must attend the orientation session.
  • I authorize the American Academy of Dermatology/Camp Discovery to conduct background checks and reference checks.
  • I will not be allowed to smoke on camp grounds.
  • The use of alcohol or any illegal drugs will be strictly forbidden.
  • I will abide by all American Academy of Dermatology/Camp and or Camp Knutson, Camp Horizon, and Camp Dermadillo's policies or risk being sent home at my own expense.

A representative of Camp Discovery will contact you for additional information.