Camp Kupugani Staff Application

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Thanks so much for your considering our staff application! We appreciate your interest in working at our camp. On the last section of this application, we ask for three references; they will need to independently submit written references (from a form e-mailed to you after you submit this online application). Please make sure that your references are not from co-workers, family members, or friends...should be from, for example, an employer, supervisor, teacher or coach.

Once we receive your three independently submitted references, we will look forward to further considering your application. (We will also notify you whether we're doing so; so feel free to check in if you haven't heard from us, since that likely means we haven't received all of the references...)

If interested in being considered, please have your references get them in soon, since we are currently evaluating applicants. Thanks again for your interest!

'Potential Staff' Information

Email
Must be unique
Title
Potential Staff First name*
Potential Staff Middle name
Potential Staff Last name*
Birthdate
1. Month
2. Day
3. Year
Gender
Primary Phone

Address Line 1*
Address Line 2
City*
Country*
State*
State*
Zip Code*

We want to attract more great campers like yours! As specifically as possible, how did you hear about us? (If returning camper, how did you originally hear about us?)

I am over 18 years old (You must be 18 years old or older to apply for a staff position)

1. Have you ever been convicted of, or pleaded guilty to, a criminal charge of child abuse or sex related crimes?

2. Are you now under allegations for any violation of the law?

3. During the past ten years, have you been convicted, imprisoned, on probation, or on parole (includes felonies, misdemeanors, firearms, or explosive violations and all other offenses)?

Adventure
1. Archery
2. Low Ropes Initiatives
3. Riflery
4. Rock Climbing Wall
5. Zip Line

Which of the following activities could you organize, coach and teach proficiently? (you must be personally skilled and experienced).
1. Animal Care
2. Astronomy
3. Biking
4. Conservation Work
5. Cooking/Baking
6. Geology
7. Juggling
8. Playground Games
9. Team Building

Creative & Performing Arts
1. Acting
2. Aerobics/Hip Hop
3. Ballet
4. Campfire Programs
5. Candle Making
6. Ceramics
7. Creative Writing
8. Dance (Folk)
9. Dance (Jazz)
10. Dance (Line)
11. Dance (Modern)
12. Drama
13. Drama (Mine)
14. Enamel
15. Guitar
16. Improv
17. Jewelry
18. Leather Making
19. Macramé/Hemp
20. Paper Crafts
21. Piano
22. Production
23. Singing
24. Sketching
25. Skits
26. Story Telling
27. Tie Dye
28. Weaving
29. Woodwork

Fitness
1. Cross Training (Aerobics/Hand Weights)
2. Karate
3. Kickboxing (Taebo)
4. Personal Training
5. Self Defense
6. Step Aerobics
7. Tae Kwon Do
8. Yoga

Outdoors
1. Backpacking/Camping Skills
2. Outdoor Cooking
3. GPS/Compassing
4. Knots
5. Mountaineering
6. Orienteering
7. Plant/Animal Identification
8. Survival Skills
9. Trail Hiking

Please indicate any additional skills here:
1. Auto Mechanics
2. Bookkeeping
3. Carpentry
4. Electrical Work
5. Food Prep
6. Kitchen - Supervision
7. Landscaping
8. Languages-French
9. Languages-Sign
10. Languages-Spanish
11. Office-Data Entry
12. PC Computer Skills
13. Secretarial Skills
14. Office-Typing
15. Web Development

Team Sports
1. Cricket
2. Football
3. Frisbee
4. Soccer
5. Softball
6. Volleyball

Water Sports
1. Canoeing
2. Fishing
3. Swimming

Absolutely NO alcoholic beverages may be brought onto camp property and no one may return to camp under the influence. I agree to adhere to this policy.

Applicant's Signature (Enter Your Social Security Number)

I hereby authorize Camp White Eagle / Camp Kupugani or authorized representatives of the company bearing this release to obtain and release any information pertaining to my background for employment or volunteer purposes.

I authorize Camp White Eagle/Camp Kupugani to investigate all statements in this application and to secure any necessary information from all my employers, references and academic institutions.

When is the best time of day to call you?

Camper Age Preference
1. Ages 7-9
2. Ages 10-12
3. Ages 13-15

Career Goal

Please indicate when you received your certifiations

Are you willing to obtain necessary certifications if you do not already have them?

City

Company 2 Describe Work

Company 2 End Date
1. Month
2. Day
3. Year

Company 2 Phone Number

Company 2 Reason for Leaving

Company 2 Start Date
1. Month
2. Day
3. Year

Company 3 Describe Work

Company 3 End Date
1. Month
2. Day
3. Year

Company 3 Phone Number

Company 3 Reason for Leaving

Company 3 Start Date
1. Month
2. Day
3. Year

Company Name

Company 2 Name

Company 3 Name

Country

Please indicate which of the following certifications you currently hold
1. First Aid / CPR
2. Lifeguard Certification
3. Water Safety Instructor
4. EMT
5. Wilderness First Responder
6. Wilderness First Aid
7. Riflery Instructor
8. Archery Instructor

Current Year in School (if applicable)

As part of being a role model in challenging oneself, will you actively participate in dam jumping at camp?

Will you be able to positively role model how to deal with wildlife (including mice and non-poisonous spiders and snakes) at camp?

Describe Work

Email Address at School

Phone Number

Employment End Date
1. Month
2. Day
3. Year

Employment History

Employment History 2

Employment History 3

Employment Start Date
1. Month
2. Day
3. Year

If you answered yes to either of the previous two questions, please describe type and purpose.

I further understand that any false or misleading statements will be sufficient cause for rejection of my application if Camp White Eagle/Camp Kupugani has not employed me and for immediate dismissal, if Camp White Eagle/Camp Kupugani has employed me.

How often do you check your email?

If you answered "YES" to any of the 3 questions above, please indicate the convictions, location, police or court dates and circumstances.

If yes, which language(s)?

Possession of, being under the influence of, or being on camp property with any illicit drug like marijuana is not permitted and may result in immediate dismissal. Will you adhere to our illegal drug policy?

I understand that Camp White Eagle/Camp Kupugani has the right to modify its policies without giving me any notice of the changes.

I want to be considered for other position(s) if my desired position is unavailable.

In the event of my employment with Camp White Eagle/Camp Kupugani, I will comply with all rules, regulations and policies set forth in Camp White Eagle/Camp Kupugani’s Personnel Policy or other communications distributed by Camp White Eagle/Camp Kupugani.

I also understand that Camp White Eagle/Camp Kupugani retains the right to terminate my employment at any time for any reason with or without cause.

Do you speak, write, or understand any foreign languages?

If in College, what's your Major?

Are you required to take any medication?

As part of being a role model in challenging oneself, will you actively participate in mud volleyball at camp?

Name of School

No promise regarding employment has been made to me, and I understand that no such promise or guarantee is binding upon Camp White Eagle/Camp Kupugani unless it is made in writing and signed by the director.

What number should we call to speak with you concerning staff possibilities?

Please describe any other ways by which you identify yourself

Phone Number at School

Camp Full Address

Camp Phone Number

Camp Director

Previous Camp Employment / Attendance
1. Counselor
2. Camper
3. Support Staff
4. No Camp Experience

Camp Name

At camp you will be giving up a great deal of privacy/comfort, working long/demanding hours, adhering to policies which may be limiting (curfew, time on, time off, etc.) I understand and will adhere to the lifestyle changes that camp may bring with it.

1. How do you think children might benefit from a camp experience?

2. What do you perceive to be the responsibilities of a camp counselor?

3. Why do you want to participate in our camp? What do you hope to gain from the program?

4. How do you think you can contribute to the program?

5. Describe both leadership positions and any experience working with children (especially 7-15 years old, if applicable).

6. Have you ever lived away from home for several weeks? When? What do you foresee being your greatest challenge with the camp lifestyle? How will you manage the challenges?

7. Please share a time when you experienced or witnessed prejudice or discrimination and how you dealt with the situation.

8. Describe what the word "multiculturalism" means to you. Please answer as if you are speaking to a 10 or 11 year-old.

9. Is there anything else you would like us to know about you?

Please describe your race(s)/ethnicity(-ies)

Reason for Leaving

Reference #1 (Please be sure to list their full name, email address, phone number and relationship to you.)

Reference #2 (Please be sure to list their full name, email address, phone number and relationship to you.)

Reference #3 (Please be sure to list their full name, email address, phone number and relationship to you.)

I hereby release all employers, references, academic institutions & Camp Kupugani from all liability arising from giving/receiving information about my employment history, academic credentials or qualifications & my suitability for camp employment.

I hereby fully release and discharge my prospective employer or other source providing information from all claims and damages arising out of or relating to any investigation of my background for said purposes.

Address at School

Smoking is not permitted on camp property at any time. Will you adhere to this policy?

Do you have any special dietary needs?

Specific Position(s) For Which I Am Applying.

State

Supervisor Name

Supervisor Name Company 2

Supervisor Name Company 3

As part of being a role model in challenging oneself, will you actively participate in swim evaluations with your campers at camp?

I understand that if an employee relationship is established, I have the right to terminate my employment at any time for any reason without penalty.

I understand that nothing in this employment application, in Camp White Eagle/Camp Kupugani policy statements or personnel guidelines or in any communication with any Camp Kupugani Official is intended to create an employment agreement with me.

Today's Date
1. Month
2. Day
3. Year

Zip or Post Code

Providing information in the following two boxes regarding race / ethnicity is optional, yet it would be tremendously helpful if you did. Because we are addressing issues of difference, it is essential that we have a diverse group of campers. We not only strive for racial/ethnic diversity, but also for diversity of socio-economic class, religion, culture, personality, etc. This information will be used only to determine this balance.

Add New Potential Staff

I accept Camp Kupugani's Terms of Service

Camp Kupugani's Terms of Service

As a staff member, you will be giving up a great deal of privacy and comfort, working long and demanding hours, adhering to camp policies which may be limiting (curfew, time on, time off, lack of privacy, etc.) I understand and will adhere to the lifestyle change that camp may bring with it.

Smoking is not permitted on camp property at any time. I agree to adhere to this policy.

Possession of, being under the influence of, or being on camp property with any illicit drug like marijuana is not permitted and will result in immediate dismissal. All staff members are expected to be ready for work with campers anytime they are on camp or at a camp function. I agree to adhere to this policy.

Absolutely NO alcoholic beverages may be brought onto camp property and no one may return to camp under the influence. I agree to adhere to this policy.

I authorize Camp White Eagle/Camp Kupugani to investigate all statements in this application and to secure any necessary information from all my employers, references and academic institutions. I hereby release all those employers, references, academic institutions and Camp White Eagle/Camp Kupugani from any and all liability arising from their giving or receiving information about my employment history, my academic credentials or qualifications and my suitability for employment at Camp White Eagle/Camp Kupugani.

I further understand that any false or misleading statements will be sufficient cause for
rejection of my application if Camp White Eagle/Camp Kupugani has not employed me and for immediate dismissal, if Camp White Eagle/Camp Kupugani has employed me.

I hereby authorize Camp White Eagle/Camp Kupugani or authorized representatives of the
company bearing this release to obtain and release any information pertaining to my
background for employment or volunteer purposes. I hereby fully release and discharge my prospective employer or other source providing information from all claims and damages arising out of or relating to any investigation of my background for said purposes.

I understand that nothing in this employment application, in Camp White Eagle/Camp
Kupugani policy statements or personnel guidelines or in any communication with any Camp White Eagle/Camp Kupugani Official is intended to create an employment agreement with me. No promise regarding employment has been made to me, and I understand that no such promise or guarantee is binding upon Camp White Eagle/Camp Kupugani unless it is made in writing and signed by the director.

In the event of my employment with Camp White Eagle/Camp Kupugani, I will comply with all rules, regulations and policies set forth in Camp White Eagle/Camp Kupugani’s Personnel Policy or other communications distributed by Camp White Eagle/Camp Kupugani. I understand that Camp White Eagle/Camp Kupugani has the right to modify its policies without giving me any notice of the changes. I understand that if an employee relationship is established, I have the right to terminate my employment at any time for any reason without penalty. I also understand that Camp White Eagle/Camp Kupugani retains the right to terminate my employment at any time for any reason with or without cause.

I accept Bunk1's Terms of Service

I HEREBY STATE THAT THE FOREGOING INFORMATION IS TRUTHFUL AND ACCURATE AND IS TO BE CONSIDERED AN
INTEGRAL PART OF ANY CONTRACT I MAY ENTER WITH CAMP WHITE EAGLE / CAMP KUPUGANI.

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