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* = Required
* First Name
* Last Name
* Email Address
* Current Address
* Current City
* Current State
* Current Zip
* Current Phone
* Permanent Address
* Permanent City
* Permanent State
* Permanent Zip
* Permanent Phone
Cell Phone Number
Best Way and time to reach you
* Earliest date you are available?
* Latest date through which you can ramain?
Where did you learn about this job opportunity?

Position(s) Applied For

Position(s) Applied for:
* Position(s):
































Educational Background

Name of School (High school, College, Graduate School)
1. Name of School
1. Field of Study
1. Degree/Credits
2. Name of School
2. Field of Study
2. Degree/ Credits
3. Name of School
3. Field of Study
3. Degree Credits

Work Experience

Descibe any leadership positions you have held?
Leadership Positions
1. Employer/Company
1. Street Address
1. City/State/ Zip
1. Supervisor
1. Telephone
1. Position
1. Dates Employed
1. Reason for leaving
2. Employer/Compnay
2. Street Address
2. City/State/ Zip
2. Supervisor
2. Telephone
2. Position
2. Dates Empolyed
2. Reason for leaving
3. Empolyer/Company
3. Street Address
3. City/State/Zip
3. Supervisor
3. Telephone
3. Position
3. Dates Employed
3. Reason for leaving

Camping Experience

Did you ever attend camp as a child?
Type of camp: (check all that apply)
How many summers did you participate in camps as a child?
Have you ever worked on a camp staff?
Complete the following for each camp.
1. Camp Name:
1. Camp City/State
1. Type of Camp: (Check all that appy in relationship to your job)
1. Camp Position(s) held
1. Was your position paid or volunteer?
1. Job responsiblities:
1. Were you eligible for rehire?
2. Camp Name:
2. Camp City/State:
2. Type of Camp: (Check all that apply in relationship to your job)
2. Postion(s) held?
2. Was your postion paid or volunteer?
2. Job responsiblities?
2. Were you eligible for rehire?

Certifications/Special Courses

1. Certification:
Expiration Date:
2. Certification
Expiration Date:

Please list any courses taken with wilderness schools/ organizations (examples: NOLS, Outward Bound, etc.)
Course/Organization:
Length of Course:
Special Skills learned:

Awards, Interests, Activities and Hobbies

Please list any awards, interests, activities and/or other experiences which you feel would prove valuable in being considered for employment.

Awards/Interests/ Activities and Hobbies:

Specific Skills

Please number as follows: 1-Proficient and can lead or direct 2- Can assit leading 3- Some knowledge

Arts & Crafts
Drawing/Sketching
Painting
Photography
Silk Screen
Jewelry Making
Tie Dye
Other:

Music/Drama

Singing
Song Leading
Guitar
Dramatics/Plays
Dance
Storytelling
Instrument (please name)
Other

Swimming (ablity)
Beginning
Intermediate
Advanced

Waterfront

Kayaking
Rafting
Canoeing
Other:

Sports & Games

Camp Games
Soccer
Basketball
Volleyball
Softball
Rock Climbing
Climbing Wall
Other Sports/Games

Ropes/Initiative

Cooperative Games
Initiatives
Low Elements
High Elements

Nature Study

Birds
Trees
Wildflowers
Animals
Astronomy
Weather
Other nature study:

Outdoor Living

Knots
Shelter Building
Fire Building
Use of Knife/Saw/Ax
Cookouts
Overnight
Camping
Backpacking
Hiking (2-5 nights)
Other Outdoor living

Horseback Riding

Western
English
Basic Riding
Trail Riding
Care of Horses
Stable Management
Teaching Experience
Other Horse:

Bicycling

Day Trips
Mt. Biking
Repair/Maintenance
Overnight Trips

Orienteering

Basic Skills

Archery

Basic Skills
Advanced Skills
Language Skills
Sign Language

Essay Questions

Please answer these questions as thoroughly as you can.
What specifically attracts you to Camp Ehawee or Black Hawk?
How do you think a camping experience can benefit a child?
What is your idea of what camp is like?
What experience or background do you have that makes you qualified for the position(s) for which you are applying? Be specific.
Tell me about a time when you worked with a group or individual that was challenging. What were the challenges and how did you handle the situation?
Tell me about any experience you have had in living and working with people of diverse backgrounds. What did you find to be the biggest benefits and challenges?
Describe how you will help campers plan activites relating to the out of doors.
Name an adult who served as your role model. What are positive things about that adult you wish to mirror?

Background Information

If hired for a position with Girl Scouts of Black Hawk Council a background check will be done. Please provide the following information.
* Have you ever been convicted of a felony?
If yes, please state offense, date and location (a conviction record will not necessarily be cause for be cause for disqualification)
Do you have a drivers license?
State of inssurance and license #:
* Have you had your dirver's license suspended or revoked in the las four years?
If yes, give details:

References

Please download and print out three (3) reference forms. Please print your name at the top of each form BEFORE distributing them. Each form should be filled out and returned directly to Girl Scouts of Black Hawk Council, Inc. by the persons who know of your skills and abilities. We recommend former employers, teachers, professors, ministers, counselors, Girl Scout leaders or other persons who can give an honest accounting of the type of person you are. References by personal friends, or relatives WILL NOT be considered. Please list the name, relationship and phone number of the three persons who will be providing your references.

It is important that your references be returned by those individuals filling them out as soon as possible. YOUR APPLICATION WILL NOT BE CONSIDERED UNTIL ALL THREE REFERENCES ARE RECEIVED.

We realize that structured applications often do not allow the applicant to express certain skills, talents, training, or other information about themselves which might be of interest to the employer. We encourage you to list below any additional information.

1. Refernce Name
1. Relationship
1. Phone Number
2. Reference Name
2. Reference Relationship
2. Reference Phone Number
3. Reference Name
3. Reference Relationship
3. Reference Phone Number
Additional Information

Waiver and Release

By clicking the agree button below, I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I understand that if I am extended an offer of employment it may be conditional upon my successfully passing a complete physical examination and current health history required by the State of Wisconsin . I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE. I am aware that I must become a member of the Girl Scouts of the U.S.A. I have read, understand, and by my signature consent to these statements.

* I agree to the previous statement:

Submit 



CBH Application 2010 Downloads Minimize
  

Reference Form Minimize

Camp Black Hawk requires you print and send out 3 reference forms. Choose your references carefully; it’s best to pick people who can speak to your experience with children as well as you abilities and skills.  It is not appropriate to use immediate family members or friends.
  

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