On-Line Employment Application

Eligibility: You must be at least 19 years old or have completed one year of college to be considered for employment with Camp Cayuga.
*First Name:
*Last Name:
*Gender:	Male Female
*Date of Birth:
Age:	Select One Less than 18 18 19 20 21 22 23-25 26+
Height:	feet & inches
Weight:	lbs.
Social Security Number:
What is your Martial Status:   Single Married Separated Divorced Remarried Widowed
Is your spouse interested in employment?		Yes   No   I have no spouse
Do you object to being assigned a roommate?		Yes   No
Do you have any children?		Yes   No
If yes, will your child(ren) accompany you to camp?		Yes   No
If yes, what is/are the age(s) and the gender(s) of your child(ren)?
Does your child(ren) have any behavioral problems or special circumstances involving physical or psychological handicaps? If yes please explain.		Yes   No
How important is it for you and your children to be housed on the same campus?
Not Important Prefer, but not necessary Very Important
Will your child(ren) sleep in a cabin with other campers or with you?		In cabin with campers   With me
Can your child(ren) sleep on a top bunk bed?		Yes   No
Does your child(ren) have any special dietary restrictions?		Yes   No
*What dates are you available for work?		Start Date:
		End Date:
Are you interested in pre-camp maintenance employment in early June?		Yes   No
Please indicate the total summer salary you desire:
Please provide the following CURRENT ADDRESS information:
*My current address is the same as my permanent address. If yes, skip the below Current Address Section and complete the Permanent Address Section.
*My current address and phone  number expires on (date)
*Current Street Address:
Address (cont.):
*City:
*State/Province:
*Zip/Postal Code:
*Country:
Current Telephone:
Current Work Telephone:
Current Fax:
*Current Email:
Alternate Email:
Cell Phone:
Please Provide PERMANENT ADDRESS Information:
*Street Address:
Address (cont.):
*City:
*Permanent County:
*State/Province:
*Zip/Postal Code:
*Country:
Home Phone:
Home Fax:
*Personal Email:
Cell Phone:
Work Telephone:
Work Fax:
Work Email:
I am currently: (Check all that apply)
	United States Citizen
	College Student
	Graduate Student
	High School Student - (no positions available to you)
	College Graduate
	Certified School Teacher
	Student Teacher
	Teacher's Assistant
	Registered/Licensed Nurse
	Medical Doctor/Physician
	Employed
	Unemployed
	My full-time job does not include summer employment.
Other:

Education:
Name of college attending/attended:
Number of years attended:
Are you pursuing a nursing degree?	Yes  No
Do you hold a medical degree?	Yes   No
Are you in pursuit of a teaching certificate?	Yes  No
Are you currently a school teacher?	Yes  No
If yes, how many years have you been teaching?
If yes, what age are the children you teach?
If yes, what subject(s) do you teach?
Are you interested in tutoring children this summer?	Yes  No
Have you tutored children in the past?	Yes  No
Are you fluent in any language?	Yes  No
If yes, what languages?

Please put a check mark next to those activities you can organize, lead and teach. You can apply for as many different positions as you'd like.
Instructor/Activity Positions:

Aerobics Animal Care/Petting Zoo Archery Arts - Air Brushing Arts - Calligraphy Arts - Ceramics Arts - Copper Enameling Arts - Kiln Operation Arts - Lanyard Arts - Macramé Arts - Painting Arts - Pottery Arts - Pottery Wheel Operation Arts - Silk Screening Arts - Sketching/Drawing Arts & Crafts Backpacking Astronomy Badminton Baseball Basketball Boating Boxing  Campfire Songs Skits Canoeing Cheerleading Chess  Chorus - Lead Singing Circus - Clowning Circus - Devil Sticks Circus - Diabolo Circus - Juggling Circus - Magic Tricks Circus - Plate Spinning Circus - Stilt Walking Circus - Unicycling Climbing Wall Cooking Cricket Dance - Ballet

Dance - Belly Dancing Dance - Choreography Dance - Hip Hop Dance - Jazz Dance - Modern Dance Dance - Social Dance - Tap Dodgeball Drama - Acting Exercise & Fitness Extreme Sport Jumping Field Hockey Flag Football Floor Hockey Flying Trapeze - High Flying Trapeze - Low Flying Trapeze-Spanish Web Fishing Foreign Languages Frisbee Gaga Golf Gymnastics-Balance Beam Gymnastics-Parallel Bars Gymnastics-Floor Exercises Gymnastics-Tumbling Gymnastics-Uneven Bars Gymnastics-Vaulting Hiking Horseback - English Riding Horseback - Western Riding Horseback - Stable Management Infirmary Assistance Jogging- Track & Field Judo Juggling Karate Kayaking Kickball Lacrosse

Lifeguard Martial Arts  Model Rocketry Mountain Biking Mountain Bike Repair Musical Instruments Newspaper Production Paintball Photography Photography Darkroom Ping Pong Quad (ATV 4-Wheelers) Radio Broadcasting Riflery Rock Climbing & Rappelling Roller Hockey Roller Skating/Blading Ropes Course - High Ropes Ropes Course - Low Ropes Rugby Sailing Scuba Diving Skateboarding Soccer Softball Swim Team Coaching Swim Instruction Tennis Trampoline  Tutoring - Academics Video Camera Operation Video Game Room Supervisor Volleyball Water Polo Weight Training Windsurfing Wrestling Yoga Zip Line

Senior Staff Positions:
Adventure & Wilderness Director Archery Supervisor ATV Supervisor Bungee/Trampoline Director Arts - Tye Dying Arts - Sign Painting Arts - Decoupage Arts - Beading Athletic Director Canteen (Camp Store) Supervisor Chef/Cook Circus Program Director Creative Arts Director Drama - Directing Plays Drama - Set Production Drama - Improvisation Driver - 15-Passenger Van (CDL required) Driver - School Bus (CDL required) Evening Activity Director Food Service Manager Gymnastics Director Head Counselor/Division Director Horsemanship Director Horseback Dressage Horseback Jumping Horseback Horse Care	Horseback Stable Manager Intercamp Games Director Kitchen Support Staff Lakefront Director Maintenance Supervisor Maintenance Support Staff Media Arts Director Nurse, Physician, Medical Assistant Office - Administration Office - Receptionist Office - Computers Office - Mailings Office - Website Paintball Director Paintball Equipment Repair Performing Arts Director Petting Zoo - Animal Care Pool Director Program Activities Director Program - Assistant Director Riflery Supervisor Special Events Director USTA Tennis Director Trips Director Transportation Director/Mechanic Trapeze Director Waterfront Director
I hold the following certifications:
Adult CPR, Child CPR, Community CPR American Canoeing Certification American Red Cross (ARC) Lifeguard ARC Water Safety Instructor (WSI) ARC Community First Aid ARC Standard First Aid ARC Sailing Small Craft ARC Wilderness First-Aid ASA Preliminary Teachers Certification ASA Teachers Certificate (European) Belay Certification Bronze Medallion (European) Boy Scouts Lifeguard Bus Driver's License CHA Certification (Horsemanship) Commercial Driver's License (limo, taxi, etc.)	EMT, RN, LPN, Nurse Practitioner, MD ESL Certification Head Lifeguard Endorsement Matial Arts NAA Archery Instructor Cerification NOLS Wilderness Ed Certification NRA Certification (Riflery) Pool/Beach Lifeguard Bronze Medallion Ropes Course Certification USTA Tennis Certification Water Park or Waterfront Endorsement YMCA Swimming Instructor YMCA Lifeguard Other Certifications (please list)

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Check all that apply:
I attended sleepaway camp as a child.
I attended day camp as a child.
I have previously worked at a sleepaway camp.
I previously worked at day camp.
I have no summer camp work experience.
I currently hold a valid driver's license and I can drive a car.
I will have an automobile at camp.
I can drive a 15 passenger van and I am 21 yrs old or older.
I currently hold a Commercial Driver's License (CDL) for driving limos, vans, etc. 
If yes, describe your CDL experience:

I currently hold a valid Bus Driver's License with school bus passenger endorsement.
If yes, describe your CDL Bus Driver experience:

I am willing to take a Commercial Driver's Test (in my home state) for transporting campers.
       (The cost of your test is reimbursable).
I have dietary restrictions.
      If checked, please explain:
I have physical/mental conditions that may limit my ability to care for/supervise children at camp.
        If checked, please explain:
I smoke cigarettes/tobacco.
I can swim.
I take prescription (RX drugs) for a medical condition or recurring disease.
      If checked, please explain:
I can lead a worship service. (Cayuga is a nonsectarian/ nondenominational private camp.)
      If checked, what religion:  

Do you have any visible tattoos that could be offensive to young children.  Yes   No
If yes, please explain:

Do you have any visible body piercings (other than ears).  Yes   No 
If yes, please explain:

Have you ever been convicted of child abuse or a sexual abuse offense?*    Yes   No

Have you ever been accused or convicted of a felony or misdemeanor?*    Yes   No
If yes, please explain:

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If applying for an instructor/counselor position, which age group do you prefer to share a cabin with? 
5 to 9 (Junior Campus) 10 to 12 (Junior Campus) 13 to 15 (Teen Campus) Any Age

If you are applying for a counselor position, keep in mind all counselors are hired as instructors. Please indicate below the activities you are most qualified to teach. Describe your personal experiences, qualifications, proficiencies, awards won and certificates earned for each of your top 3 choices. Include your experiences as a competitor/player AND as a teacher/coach for each of your top 3 areas.

What is your First Choice Instructor Position?

What is your Third Choice Instructor Position?

If you are applying for a Senior Staff position, indicate your top 2 choices below and describe the characteristics you possess that will make you an effective supervisory staff member. Include your qualifications, proficiencies, awards won, and certifications earned for each of your top 2 positions you are applying for.

If you are applying for a Medical Position (nurse, doctor, infirmary assistant) please indicate the certifications/licenses you currently hold, how long you have held the the certifications/licenses, and the extent of your experience providing medical care to children.

If you are applying for a Food Service Position, please describe the extent of your cooking skills and food service experience. Also indicate the certifications you currently hold (if any), as well as your experience in quantity food production, kitchen management (supervising staff), and operation of kitchen equipment.

For all applicants: What is your experience in working with children ages 5 to 15?

For all applicants: What do you think are the most important aspects to being an excellent staff member?

For all applicants: What contributions do you think you can make to Cayuga and its campers?

How did you first learn of Camp Cayuga?
Cayuga Staff Member.
If yes, indicate staff members name.

Cayuga Camper.
If yes, indicate Camper name.

A newspaper advertisement.

Surfing the Internet.

If you learned about us through the internet, what website directory?
Select one:	Directory List ACA Allen'sGuide.com Assoc. Of Independent Camps CampChannel.com CampDepot.com CampJobs.com CampResource.com CampSearch.com CampStaff.com ChooseACamp.com CoachFinder.com DailyJolt.com(Joltcamps.com) FindCamps.com GoCamps.com Goneawoll.com Jugglenyc.com Liberal Arts Career Network ListingsPennsylvania.com MountainBikeSite.com MySummers.com MySummerCamps.com Pa On The Web PennsylvaniaVisitorsNetwork.com PoconoVacations.com SchoolStaff.com SportsCampFederation.com SummerCamps.com Summer-Camp-Adventures.com SummerCampsInfo.com SummerCampStaff.com Summerjobs.com Summerprofiles.com TeenSummerCamps.com TennisJobs.com TheJobSpider.com WorldSiteIndex.com Other University/College
If you selected "other" website directory, please specify:
If you selected "university/college" online job career website, what university?
Select one:	University List Alfred University Arizona State University Ball State University Bluffton University Bowling Green State University Buffalo State University Carlow University Central Michigan University Cornell University University Of Delaware Delaware Valley College Depaul University Eastern Illinois University Elizabethtown College Ferris State University University Of Florida Florida Institute Of Technology Gettysburg College Goshen College Hamilton College Of Ny University Of Idaho Illinois State University Indiana University Indiana State University University Of Iowa Jacksonville University John Carrol University Kean University University Of Kentucky Keystone University Kings College Lehigh University Louisiana State University Loyola College Macalaster College Marquette University Marshall University University Of Maryland Mesa State College Messiah College Michigan State University Missouri State University Morningside College Nazareth College University Of North Carolina University Of North Dakota Ohio University Oklahoma State University University Of Pittsburgh Purdue University Roger Williams University Slippery Rock University University Of South Carolina South Illinois University Stetson University SUNY Cortland Tarleton State University Texas A&M University Towson University Virginia Tech University Of West Virginia Widener University University Of Wisconsin Xavier University Other University / College
If you selected "other university/college", please specify:

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. I also authorize Camp Cayuga to investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to provide to the camp any and all relevant information and opinions, without giving me prior notice of such disclosure. I release such persons and organizations from any legal liability in making such statements.

By checking this box, I understand and consent to these statements.*