How did you find out about Camp Don Lee?

Select Family Member On-campus Recruiting Visited as a Camper Print Ad Retreat Local Church Other

Have you been baptized?

Select Yes No

Are you a member of a local church?

Select Yes No Church Name Location (City & State) Pastor’s Name

Are you active in a congregation/local church?

Select Yes No

Are you active in other religious groups (i.e. Campus Crusade, Wesley Fellowship, BSU, etc)?

Select Yes No Please specify:

Do you have previous experience working with children?

Select Yes No Please elaborate:

Give complete educational background; attach a separate document, if needed.

High School Diploma Granted Years Attended Expected Graduation Year   College Major Years Attended Expected Graduation Year

Do you have previous camp experience?

Select Camper Staff Both

Camp Name Location Date

Give complete work history, attach separate sheet if needed. Date Employer Address Nature Of Work

Christian Education Little to No Experience Have Experience Could Lead Bible Study Leading Worship Faith Sharing Music Little to No Experience Have Experience Could Lead Song Leading Ecology Activities Instrument Outdoor Living Little to No Experience Have Experience Could Lead Camping Backpacking Orienteering Cooking Tripping Waterfront Little to No Experience Have Experience Could Lead Canoeing Sailing Swimming Nature Education Little to No Experience Have Experience Could Lead Fishing Nature Crafts Stargazing Night Nature Miscellaneous Little to No Experience Have Experience Could Lead Group Games Storytelling Drama Challenge Course

First Reference Address Zip Code Phone Number Cell Phone E-Mail

Second Reference Address Zip Code Phone Number Cell Phone E-Mail

Third Reference Address Zip Code Phone Number Cell Phone E-Mail

CAMP DON LEE IS A RUSTIC OUTDOOR SETTINGS. STAFF ARE REQUIRED TO TRAVERSE INDEPENDENTLY AND ARE ENTRUSTED WITH THE CARE OF A GROUP OF CHILDREN WHOSE HEALTH AND WELFARE ARE YOUR PRIME RESPONSIBILITY. DO YOU HAVE ANY IMPAIRMENT, PHYSICAL OR MENTAL, WHICH WOULD INTERFERE WITH YOUR ABILITY TO PERFORM THE JOB FOR WHICH YOU HAVE APPLIED? Yes No IF SO, WHAT ARE THEY?

The camp’s policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment. Have you ever been accused of harassment of any person including, but not limited to, work place harassment? (Note: a prior accusation is not an automatic bar to employment. The type of accusation and when it occurred will be evaluated by the camp before any decision is made.) Yes No Explain

Have you been convicted of a crime, other than a minor traffic offense?  If yes, please describe.  (Note: a prior conviction is not an automatic bar to employment.  The type of conviction and when it occurred will be evaluated by the camp before any decision is made. ) Yes No Explain

On a separate sheet, complete a one-page biographical sketch, including specialized training in camping, and experience in other fields which might have a bearing on the positions for which you are applying.

The above information is true and correct to the best of my knowledge. I authorize the camp to contact anyone regarding my experiences or background and release from harm or liability any statements