Work at New Image Camps

Thank you for taking the time to apply for a position at one of our summer programs. Please note that only complete application forms will be considered.

NOTE: Fields in red are required.

Address Information

First Name: Last Name:

Address 1:

Address 2:

City: State: Zip:

Country:

Home Phone: Work Phone:

Email: Fax:

Present Address (If Different From Above)

Address 1:

Address 2:

Country:

City: State: Zip:

Present Telephone (If Different From Above)

Home Phone: Work/College Phone:


General Information

Date after which permanent address is to be used:

Date of Birth:

Height: Weight: Gender:

Marital Status: If married, must family accompany you to camp?

If yes, please provide sex and age of your children:

Are you a Full Time Student? If NO, occupation:

Social Security Number:


Do you smoke? Do you drink alcohol?

Have you ever been convicted of a felony or misdemeanor within the past 5 years?

If yes, please explain? (NOTE: You will not be denied employment solely because of a conviction record, unless the offense is related to the position for which you are applying.)

Activities

Below you will find a variety of activities that are taught at Pocono Trails. Please indicate your level/ability to teach. If you have taught an activity, please give specific details of your Teaching Experience.

Instructions
Select "1" for those activities which you can organize and teach.
Select "2" where you feel you can assist confidently and competently.

Athletics KEY:    1=Organize & Teach      2=Assist
1 2   1 2   1 2   1 2
Archery Martial Arts Street Hockey Softball
Baseball Newcombe Team Handball Lacrosse
Basketball Ping-Pong Tennis Wrestling
Football Riflery Volleyball Soccer
Golf Roller Blading Weight Training Ice Hockey

Water Sports
KEY:    1=Organize & Teach      2=Assist
1 2   1 2   1 2   1 2
Canoeing Life Guarding SCUBA Kayaking
Comp. Swim Life Saving Snorkeling Sailing
Fishing Motor Boating Swim Instruct Wind Surfing

Water Skiing
KEY:    1=Organize & Teach      2=Assist
1 2   1 2   1 2   1 2
Water Skiing Kneeboard Trick Barefoot
Boat Driver Skurfing Wake Board Slalom

Adventure & Nature
KEY:    1=Organize & Teach      2=Assist
1 2   1 2   1 2   1 2
Animal Care Canoe Trips Nature Camping
Backpacking Climbing Wall Orienteering Horseback Riding
Camp Fire Prog Hiking Rock Climbing Ropes Course

Arts & Crafts
KEY:    1=Organize & Teach      2=Assist
1 2   1 2   1 2   1 2
Cartooning Leather Stained Glass Painting
Ceramics Model Making Woodworking Drawing

Specialties
KEY:    1=Organize & Teach      2=Assist
1 2   1 2   1 2   1 2
Dramatics Photography 2nd Chef Piano
Computer Radio Kitchen Mgt Chef
Music Rocketry Nurse(RN) EMT
Guitar Secretary LPN Newspaper


Education

Please select the level of education completed at close of current academic year:

College: Graduate School:


High School Information:

Years Attended:

Name of School:

City/State:


College Information:

College 1 College 2


Name of School:

Location (City/State):

Years Attended:

Major/Degree

References

References listed should not be relatives and should have knowledge of your character and suitability to work with children. Please include any camp, coaching, and/or teaching experiences.

Name:

Known how long:

Address:

City/State/Zip:

Telephone #:


Name:

Known how long:

Address:

City/State/Zip:

Telephone #:


Please describe your experience in a specific program area you would like to teach at camp
(i.e. certifications, training, team play).


Please describe any experience that you have that would make you a successful camp counselor:


Optional


Please copy/paste your resume in the space below:

Or attach it here:


Agreement

Please read carefully before sending this application.

The statements in this application are true and correct. I understand that any misrepresentation or omission of information shall be considered sufficient reason for withdrawal of an offer, or subsequent termination of employment. I hereby authorize Pocono Trails to conduct a personal felony record search. By electronic submission of this application to Pocono Trails, I understand and agree to the conditions stated above.

Please Initial: