SHENANDOAH AREA COUNCIL, BOY SCOUTS OF AMERICA 107 Youth Development Court, Winchester, VA 22602
(540-662-2551)
CAMP ROCK ENON SUMMER CAMP APPLICATION STAFF APPL
CIT
Name
Social Security #
Address Home Phone(
Date of Birth:
City )
Work/School Phone (
State )
Zip
Cell Phone
E-Mail US Citizen?
If not, have you declared your intention to become a citizen?
High School
Location
Dates
College/Vocational
Location
Dates
Diplomas, Certificates, Degrees or Awards Management Positions _____Camp Director _____Business Manager
_____ _____
Program Areas _____Aquatics (Swimming, Rowing, Canoeing, Lifesaving) _____Outdoor Skills & Frontier (Pioneering, Cooking, Camping) _____Handicraft (Leatherwork, Woodcarving, Basketry, Indian Lore) _____High Adventure (Caving, Canyoneering, Backpacking, White Water)
_____Climbing and Field Sports (Athletics, Personal Fitness) _____ Nature and Ecology (Envi. Science, Forestry, Fishing) _____ Shooting Sports (Shotgun Shooting, Rifle, Archery) _____ Commissioner
Support Positions _____ Dining Hall _____ Medic _____ Quartermaster
_____ Trading Post _____ Assistant Ranger _____ Administrative Assistance
What Scout rank do you hold?
Program Director Cook
Leadership Positions Held
Are you an Order of the Arrow Member?
What Honor?
Current Certifications (Lifeguard, First Aid, CPR)
REFERENCES (Print names, addresses, phone numbers, relationship dates and capacity): UNIT LEADER (Do not use family as references):Name EMPLOYER (Do not use family as references):
Phone Number
Name
Phone Number
Address
City
State
Zip
State
Zip
Reason for leaving: SCHOOL (Do not use family as references): Name
Phone Number
Address
City
ALCOHOLIC BEVERAGES AND DRUGS ARE NOT ALLOWED ON CAMP PROPERTY! Salary required: Weekly ___________ or Camping Season ____________ Note: Meals and lodging provided while at camp. CIT’s do not get paid. Applicants over age 18 agree to a background check: Signature Required
Applicants Signature
Date
Scoutmaster Signature
Date
Parent or Guardian signature (if under age 21)
Date