Online Form


CHECK ONE

I have been a Camp Happy Days Counselor Before This my year

This is my first time applying to be a Camp Happy Days Counselor

CAMP DATES: Saturday, June 28 - Saturday, July 5, 2008

COUNSELOR ORIENTATION — June 14, 2008, at Camp Bob Cooper in Summerton, SC. Orientation is mandatory for individuals who did not participate in Camp Happy Days 2007.

CONFIDENTIALITY: The information received from this application shall be maintained as confidential and shall not be distributed outside the organization, for any purpose other than to complete the application review process.

Please complete:

Full Name


Age


Date of Birth


Address


City


State


Zip


Country


Home Phone


Work Phone


Cell Phone


Email


T-Shirts


CAMP POSITION DESIRED - rank your interest for each of the following

Preference 1

Preference 2


Preference 3


CAMP COUNSELOR WITH KIDS

If you are interested in being a Camp Counselor with kids, select ONE preferred age group.

IMPORTANT NOTE: Your selection serves only as a tool for staff when making assignments. Assignment to the age range selected below is not guaranteed.



PROGRAM AREA TEAM MEMBER
If your preference is to work in a program area rather than as a camp counselor assigned to a specific group of kids, select TWO areas where you have skills or interests:

Preference 1


Preference 2


MEDICAL STAFF VOLUNTEER: I am a…
MD
RN
LPN
EMT
Paramedic

Current license(s), employer and position held:


List any experience working with children, please specify age groups:


References Please provide two character references (non family members):

Reference 1
Name


Home Phone


Adress


Work Phone


Reference 2
Name

Home Phone

Adress

Work Phone