Employment Application

First Name: Last Name:

Street Address: City: State: Zip:

Home Phone: Cellphone: Birthdate:

Present Occupation: Gender Select Gender MALE FEMALE

Email Address:

Educational Background

Work Experience (List PAID EXPERIENCE in order of most recent position.)

Volunteer Experience (List any VOLUNTEER EXPERIENCE you have had.)

Experience with Children (What related experience with children have you had? Teaching, babysitting, etc. (include ages & gender)

Certifications - Please indicate any CURRENT certifications you have below.

Character and References - List 3 people who know of your work such as teachers, employers, etc. No family members, please.

Have you ever been charged, either criminally or civally, with sexual abuse, sexual harassment or discrimination? YES NO

Have you ever been convicted of a felony? YES NO

If you answered YES to either of the last two questions, please explain.

Activities - Select "LIKE" next to the activites that you like to do. Select "TEACH" next to activities that you could teach or help teach.

Summer Positions

What experience, if any, do you have teaching swimming?

What general camp experience have you had, if any? Describe.

Are there any obligations requiring you to need time away from summer camp?

How did you hear of Purchase Day Camp? If through a friend, who?

The following question is to prevent spam and must be answered correctly to submit the application. The color of a ripe pumpkin is...?