CSC STAFF APPLICATION 2021
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PERSONAL INFORMATION
Please answer each question completely. All information is required.
Name (First, Middle, Last) *
Birthdate (Month, Day, Year) *
MM
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DD
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YYYY
Age as of June 18, 2021 *
Phone Number *
Email *
Permanent Address (Street, City, State, Zip) *
School/College/Employment *
Major/Course of Study
GENERAL INFORMATION
Please understand that no specific answers preclude your consideration for a position.
Are you fully available from Friday, June 18-Thursday, August 19, 2021 (Please note that dates may change depending on regulations in regard to COVID 19) *
If you answered no to the question above, please give dates and explanation for when you are not available.
Do you have a legal right to work in the United States? *
Camp Susan Curtis will conduct a criminal background check that includes the National Sex Offender Registry. Have you ever been convicted of a crime other than a minor traffic violation? *
If you answered yes to the question above, please provide the date and a brief explanation.
Camp Susan Curtis prohibits all forms of harassment by or toward our employees including sexual, racial, religious, and other forms. Have you ever been accused of harassment of any individual? *
If you answered yes to the above question, please provide a brief explanation.
Are you permitted to carry a concealed weapon in the State of Maine? *
EMPLOYMENT EXPERIENCE
You may email a resume to terri@susancurtis.org for this section as long as all information is available.
Employment/Volunteer Experience 1-Please list Company, Position, Supervisor Contact Info, Dates Worked, Reason For Leaving
Employment/Volunteer Experience 2-Please list Company, Position, Supervisor Contact Info, Dates Worked, Reason For Leaving
Employment/Volunteer Experience 3-Please list Company, Position, Supervisor Contact Info, Dates Worked, Reason For Leaving
CERTIFICATIONS
Please list any certifications you hold, relevant to camp, that will be valid through August 2019. Lifeguard, Archery, First Aid, etc.
Certifications (with dates)
REFERENCES
3 Reference Forms are required. These are part of the Application Packet.
INTEREST INVENTORY
Please check the position(s) or program(s) you are most interested in. Not all positions may be available.
Please rank the areas you are most interested in with 1 as Highest and 5 as Lowest. This is interest...not skill or experience.
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2
3
4
5
Creative Arts
Environment, Nature, Outdoor Skills
Ropes Course & Teambuilding
Sports & Games
Waterfront
Clear selection
Please list a talent/interest/activity/hobby you enjoy that you would be willing to share with campers during a 70 minute activity period. We encourage more than one.
Prior to camp starting we offer Certifications at CSC and other locations. Please check below anything you would be interested in pursuing. We pay for most certifications or offer a discounted rate.
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