Junior Counselor Application 2018
Thank you for your interest in becoming a Junior Counselor (JC) at Broadturn Farm Camp! Our 15-17 year old volunteer Junior Counselors offer their time and service as counselors in exchange for an opportunity to learn about early childhood education and sustainable farming. Volunteer JC's must commit to at least two weeks of service, and must be available for Junior Counselor training on a date to be determined.

Please fill out the form below to submit your application. In addition, email a letter of reference as an attachment to megan@broadturnfarm.com. In the subject line, type 'junior counselor reference'. If you have worked with us in the past as a JC, you may skip sending us a letter of reference (as we probably already know you well!).

All applications and letters of reference must be received by June 1st and will be reviewed as they are received.

You will be contacted by email if you have been chosen to be a Junior Counselor, and to confirm your dates of service. If you have any questions about the program or have trouble filling out the form, please contact us at megan@broadturnfarm.com or call Megan at 207.510.4822, ext 4.

It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

Name of applicant (last, first) *
Your answer
Street address *
Your answer
City, state, zip code *
Your answer
Phone number(s) *
Include cell and home phone, if applicable
Your answer
Email address *
Your answer
Date of birth *
Applicant must be 15 years old prior to the start of camp
Your answer
Why do you want to be a Junior Counselor at Broadturn Farm Camp?
Your answer
What do you think you can contribute to camp as a Junior Counselor?
List skills, interests, experience
Your answer
Please list at least two non-related references (ie: school teacher, coach)
List full name, telephone number, email address, and relationship to applicant. A letter of reference from one of these must be emailed or mailed separately.
Your answer
Any required medications, allergies, and/or health issues? *
Your answer
Emergency Contact *
Please include name, address, home and cell phone numbers and relationship to JC.
Your answer
Health history statement and parent consent *
I state that the health history above is correct. My child has permission to participate in all farm camp activities. I understand these activities may include certain risks. I authorize Broadturn Farm (1) to secure emergency medical care at my expense if I am unable to be reached in the event of an emergency; (3) to use my child's photo in promotional materials. I specifically release The Broadturn Farm, its owners, directors, employees, and volunteers from any claim of any kind arising from my child's participation in Broadturn Farm's programs.
Applicant's agreement and signature: Please type your full name and date in the space provided *
By providing this electronic signature, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a Junior Counselor, any false statements, omission, or other misrepresentations made by me on this application may result in my immediate dismissal.
Your answer
Weeks of service
Volunteer JC's must commit to at least two weeks of service
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