4-H Camp Counselor Application
Purple Power Pack
Counselor Training: June 5, 2018 - 5:00 pm
Camp: June 6 - June 9, 2018

If you are chosen as a Junior (finished 8th Grade) or Senior Counselor (must be 16 years old) there will be a fee of $50.00 payable by May 21, 2018.

T-Shirt Size *
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Mailing Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Parent or Guardians Name *
Your answer
Parent or Guardians Emergency Phone Number *
This number may be different than the phone number listed above
Your answer
Badge Name: *
For example: Elizabeth Smith may go by Liz Smith or Jonathan Smith may go by Jon Smith
Your answer
Age on June 5, 2018 *
Your answer
Grade Completed May 2018 *
Your answer
Please list any special requirements due to a physical, vision, hearing, or dietary restriction.
Your answer
I understand that I must attend counselor training on Tuesday, June 5 and Wednesday, June 6. *
Please rank below your preferences for age of campers you would like to work with at camp. *
Grade 2 - 3
*
Grade 4 - 5
*
Grade 6 - 7
If you have been a camp counselor in past years, answer questions 1 - 3 and 7 - 9. If you have not been a camp counselor, answer only questions 1 - 6c.
1. Why do you want to be a camp counselor? *
Your answer
2. Please list any training related to serving as a camp counselor that you have had previously. *
For example, Lifeguard, EMT, Basic First Aid, Counselor Training
Your answer
3. Describe any experiences you have had working with small groups of elementary age youth. *
Your answer
4. Please explain your camping experiences. *
Include years of camp, types of camps, previous counselor experiences.
Your answer
5. In your opinion, what is the most important trait of a camp counselor, and why? *
Your answer
6a. As a counselor, how would you handle name calling? *
Your answer
6b. As a counselor, how would you handle homesickness? *
Your answer
6c. As a counselor, how would you handle a camper that tends to be a "loner?" *
Your answer
Answer the following questions (7 - 9) if you have served as a 4-H Counselor in past years.
7. How many years have you served as a 4-H Camp Counselor?
8. What did you learn from your 4-H Camp Counselor Experience?
Your answer
9. Since last serving as a 4-H Camp Counselor, what new skills and experiences have you learned that could help you this year?
Your answer
10. Please rank your choices of the following 4 committees?
1 being your top choice and 4 your bottom choice
Campfire
Ending Camp Ceremony
Flag Ceremonies
Meal Inspiration
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