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New Staff Application Please take the time to fill out the application as complete as you can. You must fill in the references section for the application to be processed. Last Name: First Name: Gender Male Female Permanent Home Address: Address: City/town: Province: Postal Code: Telephone: Cell phone: Email: Best days to reach you: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Temporary/School Address: Address: City/town: Province: Postal Code: Telephone: Best days to reach you: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Dates at this address: Are you currently attending school?: Yes No School attending: Major/Specialization/Course: Highest grade/diploma/degree completed by June 2008 Are you planning on attending school in September: Yes No Are you legally entitled to work in Canada? Yes No Our campers range in age from 5-15. It is important for us to hire staff of the appropriate age. Will you be 16 years of age or older by July 1, 2008? Yes No While it is not required at this time, it would be helpful for us to know your date of birth (day/month/year): What position are you applying for? Are you available for the entire camp season (June 29 - Aug 23, 2006) Please note, preference is given to those who are available for the entire camping season, but we are willing to work with those who can commit to two or more weeks at camp this summer. Yes No If no what dates are you available for? Experience List all jobs you have had, volunteer or paid and please note any positions working with children. Organization Positions and Responsibilities Dates Worked Are you currently working? Yes No Employer: Phone# : Duties: Can we contact this person for a reference if required? Yes No Please indicate your camping experience in the following categories: # of years as camper at Lambton Centre # of years as camper at another camp # of years as staff at Lambton Centre # of years as staff at another camp LIT at Lambton Centre? Yes No LIT/CIT training at another camp? Yes No Name of Camp: Please outline your qualifications and teaching experience in the following areas. Please put a check mark beside only those of the following activities / areas in which you feel you can provide instruction. Area Awards / Experience / Qualifications Archery Art and Crafts Canoeing Drama Initiatives, Low Ropes etc. Ecology / Nature Christian Education Music-piano; guitar; singsong Swimming (NLS, Bronze Cross?) Juggling, Ballooning etc. Writing, Poetry Game Leading Fine Arts - pottery, drawing etc. Moutain Biking Movie Making Desktop Publishing Photography Other qualifications: First Aid Yes No CPR Yes No What do you think you can contribute to Lambton Centre this summer? Please tell us one memorable thing about yourself that will help us get to know you better. How did you find out about Lambton Centre? Is there anything else you would like to tell us about yourself? References Please give the names and phone numbers Reference #1 First Name: Last Name: Relationship (teacher, employer, coach etc): Phone Number: Email Address: Address: City: Reference #2 First Name: Last Name: Relationship (teacher, employer, coach etc): Phone Number: Email Address: Address: City:

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