Name
Sex
Male
Female
Home Address
City
Prov/State
Postal Code/Zip
Email
Where did you hear about Camp Walden?
CURRENT ADDRESS (If Different from Above)
Address
City
Prov/State
Postal Code/Zip
Phone
I will be at the current Address until:
School Grade
Date of Birth
Occupation if Not Student:
What position are you applying for?
What salary do you expect?
ACTIVITY QUALIFICATIONS
In the following list, mark "1" beside those in which you are able to participate, "2" beside those in which you are proficient, "3" beside those in which you are qualified to instruct or lead.
LAND SPORTS
Archery
1
2
3
4
5
6
Tennis
1
2
3
4
5
6
Basketball
1
2
3
4
5
6
Soccer
1
2
3
4
5
6
Volleyball
1
2
3
4
5
6
Baseball
1
2
3
4
5
6
Football
1
2
3
4
5
6
Fitness & Aerobics
1
2
3
4
5
6
Self Defense
1
2
3
4
5
6
(Which Ones)
(Other)
OUTDOOR SKILLS
Canoe Tripping
1
2
3
4
5
6
Campfire Programs
1
2
3
4
5
6
Orienteering
1
2
3
4
5
6
Pioneering
1
2
3
4
5
6
Outdoor Cooking
1
2
3
4
5
6
Overnight Camping
1
2
3
4
5
6
Nature
1
2
3
4
5
6
Fishing
1
2
3
4
5
6
Environmental Studies
1
2
3
4
5
6
Ropes/Climbing Walls
1
2
3
4
5
6
Walls
1
2
3
4
5
6
(Other)
WATERSPORTS
Swimming
1
2
3
4
5
6
Sailing
1
2
3
4
5
6
Canoeing
1
2
3
4
5
6
Water-Skiing
1
2
3
4
5
6
Kayaking
1
2
3
4
5
6
Snorkeling
1
2
3
4
5
6
Wind Surfing
1
2
3
4
5
6
(Other)
PERFORMING ARTS
Musical Theatre
1
2
3
4
5
6
Drama Workshops
1
2
3
4
5
6
Mime
1
2
3
4
5
6
Dance
1
2
3
4
5
6
(Specify)
Story Telling
1
2
3
4
5
6
Music
1
2
3
4
5
6
Which Instrument(s)
Song Leading
1
2
3
4
5
6
SECRETARIAL
Typing
1
2
3
4
5
6
Basic Bookkeeping
1
2
3
4
5
6
Computer
1
2
3
4
5
6
List Programs
1
2
3
4
5
6
Phone Skills
1
2
3
4
5
6
LEADERSHIP SKILLS
Evening Programs
1
2
3
4
5
6
Discussion Groups
1
2
3
4
5
6
Staff Programs
1
2
3
4
5
6
Section Programs
1
2
3
4
5
6
Camp Wide Programs
1
2
3
4
5
6
Rainy Day Programs
1
2
3
4
5
6
VISUAL ARTS
Ceramics/Pottery
1
2
3
4
5
6
Camp Newspaper
1
2
3
4
5
6
Film & Video
1
2
3
4
5
6
Photography
1
2
3
4
5
6
Graphic Arts
1
2
3
4
5
6
(Which Ones)
Arts
1
2
3
4
5
6
(Which Ones)
Crafts
1
2
3
4
5
6
(Which Ones)
Copper Enameling
1
2
3
4
5
6
Jewelry Making
1
2
3
4
5
6
FOOD SERVICE
Cooking
1
2
3
4
5
6
Restaurant Experience
1
2
3
4
5
6
Maintenance
1
2
3
4
5
6
Please expand on areas in which you are particularly skilled.
REFERENCES FOR CAMP EXPERIENCE - ON STAFF
1.
2.
3.
1
2.
3.
CAMP EXPERIENCE - AS A CAMPER
1
2
3
Swimming Ability:
Non-swimmer
50 Meters
100 Meters
300 Meters
Swimming or Life-Saving Awards Held:
Other Awards Held:
CHILD ABUSE AND CHILD MOLESTATION
This has become a highly volatile and sensitive issue in the law courts of North America. Our parents along with all of the staff want to ensure that our campers have a safe and enjoyable time at camp. Please help us by answering the following questions:
Do you have a past criminal record
or have you been questioned regarding
child abuse and/or child molestation?
Yes
No
Do we have permission to check police
records re: information on any convictions?
Yes
No
Comments:
YOUR BELIEFS AND IDEAS
Please be as detailed as possible with your answers.
Why do you want to go to camp?
What do you think your contributions to our camp would be if you worked at Walden?
What do you think your personal strengths and weaknesses are - as far as working with children in a camp setting?
This space is provided in order for you to tell us anything else about yourself that might be helpful
in assessing your application.
The more information you can give us the better.
Current Date:
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