subject_line
Employment Application
First Name:
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Last Name:
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Gender:
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Male
Female
Current Age Status:
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17 and under
18 and over
21 and over
Street Address:
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City:
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State:
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Zip Code:
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Primary Phone Number:
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Secondary Phone Number:
E-Mail Address:
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Education
Are you currently a student?
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Yes
No
Name of Current School or School Last Attended:
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High School Name:
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High School Grade Completed:
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9th
10th
11th
Graduated
GED
College Status in August 2018:
N/A
Freshman
Sophomore
Junior
Senior
Graduate
Working towards Master's Degree
Graduated with Master's Degree
College Major:
Degree Earned (if any):
Past Employment
Name of Current/Most Recent Job:
Type of work:
City:
State:
Dates Worked:
Reason for Leaving:
Name of Previous Job 2:
Type of work:
City:
State:
Dates Worked:
Reason for Leaving:
Name of Previous Job 3:
Type of work:
City:
State:
Dates Worked:
Reason for Leaving:
Current Certifications/Credentials
CPR:
Standard First Aid:
Advanced First Aid:
EMT:
Lifeguard:
Water Safety Instructor:
LPN/RN:
Teaching Certificate:
Epi-Pen:
Other (please specify below):
Open Ended Questions
Why are you applying to work at Super Stars Camp?
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What strengths do you feel you would bring to the job?
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Have you ever worked with children before? If so, explain in what capacity and if not, explain why you are interested in working with children:
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Have you ever been convicted of a felony or misdemeanor?
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Yes
No
If yes, please indicate the dates and circumstances:
Have you ever been convicted of child abuse or a sexual offense?
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Yes
No
References
Please list only professional references: Employer, Advisor, Coach, etc., and provide a valid email address for each.
Name of Reference 1:
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Email Address:
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Phone Number:
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In what capacity do you know this person?
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Coach
Guidance Counselor/Academic Advisor
Employer
Religious Leader
Supervisor
Teacher/Professor
Name of Reference 2:
Email Address:
Phone Number:
In what capacity do you know this person?
Coach
Guidance Counselor/Academic Advisor
Employer
Religious Leader
Supervisor
Teacher/Professor
Name of Reference 3:
Email Address:
Phone Number:
In what capacity do you know this person?
Coach
Guidance Counselor/Academic Advisor
Employer
Religious Leader
Supervisor
Teacher/Professor
Review Application
Certification and Release (Please check the box below to digitally sign this document):
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To the best of my knowledge and belief, the information given truly represents my background and experience. I understand that if I have knowingly or negligently misrepresented, falsified or omitted any information during the application process, I may be disqualified for employment consideration or dismissed from employment with Super Stars Camp.
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