Cody Employment - Apply Now

First Name:

Last Name:

Social Security Number:

Date of Application:

Earliest Date Available:

Latest Date Available:

E-mail Address:

Present Mailing Address

Street:

City and State:

Zip:

Phone:

Home Address (If different)

Street:

City and State:

Zip:

Phone:

What position are you applying for?

Group Leader LPN Maintenance

Head Counselor RN Laundry

Activity Leader Kitchen Other

Activity Specialist

Which Specialty?:

Salary Requested:

Do you meet or exceed any minimum age requirements for that position?

Can you perform the essential functions of the job for which you have applied, with or without reasonable accommodation?

Are you willing to live in a camper cabin as one of two or three staff members within that cabin?

Marital Status:

If you are hired would you desire or need housing for any person(s) other than yourself at the camp?

If yes, please explain:

Do you have children?

Do you have children of camp age(7-15)?

Have you ever been accused or involved in an incident involving sexual or physical abuse of a child?

Education

	Institution	Dates	Degree/Major
Professional
University
High School

Please explain any gaps in educational experience:

Work Experience

	Name & Address	Dates	Position
Employer 1
Employer 2
Employer 3

Please explain any gaps in employment history:

Indicate any employer you do not wish us to contact, and the reason:

Activities & Involvements

	Name & Address	Dates	Job Title & Responsibilities
Activity 1
Activity 2
Activity 3

References

Please do not include any family members in this section

	Name & Title	Phone	Address
Reference 1
Reference 2
Reference 3

Activities

Click the box to the left of the activity you can assist in, or organize and teach.

Baseball	Canoeing	Choral	Camp Newspaper
Basketball	Kayaking	Guitar	Indian Lore
Field Hockey	Sailing	Piano	New Games
Lacrosse	Ski Boat Driving	Acting	Storytelling
Roller Hockey	Swimming	Directing	Darkroom
Rugby	Water Skiing	Magic	Photography
Soccer	Wind Surfing	Juggling	Radio
Softball	Ceramics	Script Writing	Video
Street Hockey	Drawing	Costuming	CPR
Volleyball	Jewelry Making	Electrical	First Aid
Archery	Leatherwork	Lighting	Life Saving
Badminton	Native Crafts	Makeup	Small Crafts
Croquet	Painting	Set Construction	WSI
Fishing	Paper Mache	Aerobics	Backpacking
Golf	Pottery	Choreography	Campfires
Gymnastics	Rocketry	Folk	Environmental Study
Horseback	Sculpture	Modern	Orienteering
Karate	Silk Screening	Square	Outdoor Cooking
Riflery	Tie Dying		Overnights
Tennis	Woodwork		Ropes Course
Weight Fitness

Certifications and Camp Support Staff Skills

In the following list, please select "Skilled" for those items in which you have experience and skills.
Select "Certified" for those which you hold current certification and send a copy for your certification.

Business Administration

Bookkeeping/Accounting

Health & Safety

CPR

Computer/Technical

First Aid

Computer/Software

Lifeguard

Other(Please Specify)

Nursing

Other(Please Specify)

Maintenence

Auto Mechanic

Food Service

Cooking/Meal Preperation

Carpentry

Food Handler's Permit/Certificate

Electrical

Menu Planning

Plumbing

Purchasing

Other(Please Specify)

Sanitation

Other(Please Specify)

Answer these questions only if applying for a position requiring driving:

Do you have a valid driver's license?

State:

Do you have a current chauffeur's-type license?

Do you have a commercial driver's license?

Open-Ended Questions

Write a brief biographical sketch; include any specialized training or related experience that may have a bearing on the position(s) for which you are applying:

Please list any relevant and up to date certifications you may have (for example:Lifeguard Certified, First Aid, etc.):

Harassment

The camp's policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment. Have you ever been accused of harassment of any person including, but not limited to, workplace harassment?

If yes, please explain:

Note: A prior accusation or conviction is not an automatic bar to employment. The type of conviction or accusation and when it occurred will be evaluated by the camp before any decision is made.

Criminal Record

Have you ever been convited of a crime, other than a minor traffic offense?

If yes, please explain:

Note: A prior conviction is not an automatic bar to employment. The type of conviction or accusation and when it occurred will be evaluated by the camp before any decision is made.

Privacy Statement

I authorize investigation of all statements herein, including any checks of criminal records, and release the camp and all others from liability in connection with same. I understand that, if employed, I will be an at-will employee unless there is an agreement or law which alters that status. Futhermore, I understand that any agreement must be in writing and signed by the designated camp official. I also understand that untrue, misleading, or omitted infromation herein or in other documents completed by the applicant may result in dismissal, regardless of the time of discovery by the camp.

Initial Here: