The Teresa Group Volunteer Summer Camp Counsellor Application Form
Volunteer Camp Counsellors are being recruited for our one-week overnight camp to work with campers in developing their self-confidence, independence and building friendships together with a spirit of cooperation. Camp will take place August 11 to 17 2019.
Name (first and last) *
Your answer
Gender (as you identify) *
Your answer
Street address *
Your answer
City *
Your answer
Province *
Your answer
Permanent address (if different from above)
Your answer
Email address *
Your answer
Confirm email address *
Your answer
Primary phone number *
Your answer
Alternative phone number (optional)
Your answer
Are you at least 18 years old (counsellors must be 18 years or above) *
If you are accepted as a volunteer counsellor, may we release the following to other volunteers and medical staff? *
yes
no
email address
phone number(s)
How did you hear about The Teresa Group's summer camp?
Your answer
Have you ever worked with persons living with/affected by HIV? If yes, please explain. *
Your answer
Please rank the age group you are most interesting in working with (1 = more interested to 3 = less interested). We will do our best to place you in a position of your choice, but cannot guarantee that you will be assigned your preference. Cabin counsellors are responsible for the campers in their assigned cabins. *
1
2
3
4
Juniors (9-11 years)
Intermediates (12-14 years)
Seniors (15-18 years)
Support Counsellor (helps all cabins)
Please list any past experience working with children and/or youth (name of organisation; start and end dates; position) *
Your answer
Please provide the following information for your past 3 employers, starting with the most recent: Name of employer, Position, start and end dates, reason for leaving *
Your answer
High School: Name, City, Year of Graduation
Your answer
College or University: Name of institution, Course of Study, Year of Graduation
Your answer
Supervisory Reference #1 (please do not list family, friends, relatives or co-workers). include name, occupation, phone number, email address *
Your answer
Supervisory Reference #2 (please do not list family, friends, relatives or co-workers). include name, occupation, phone number, email address *
Your answer
Supervisory Reference #3 (please do not list family, friends, relatives or co-workers). include name, occupation, phone number, email address *
Your answer
All volunteer counsellors must be CPR Level C and First Aid certified prior to the start of camp. If you do not have current valid certification you must make arrangements to obtain this prior to camp. Are you currently certified for: *
Yes
No
CPR Level 3
First Aid
Do you currently hold any of the following certifications:
Please tell us about any other relevant skills you have
Your answer
Please list any languages you speak in addition to English
Your answer
Please tell us about any special dietary requirements you have: *
Please tell us about any allergies or food sensitivities you have:
Your answer
Please tell us about any physical challenges or medical conditions which would require accommodation during camp
Your answer
All volunteer counsellors must attend a mandatory full day of training on Saturday July 13th 2019. *
The camp site is smoke-free, with the exception of approved campfires *
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