Youth - Seasonal Application For Summer Camp Staff - Boy Scouts Of America
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1
2
3
4Check camp applying to:
YOUTH
Grand Canyon Council, Inc.
Camp Geronimo
Boy Scouts of America
Camp Raymond
S
A
EASONAL
PPLICATION FOR
2969 North Greenfield Road
Heard Scout Pueblo Cub Day Camp
Phoenix, AZ 85016-7715
R-C Cub Scout Adventure Camp
S
C
S
UMMER
AMP
TAFF
(602) 955-7747
Lake Pleasant Aquatics Camp
(for 14 to 17 years of age)
First & Last Name:________________________________ Phone: (
) ____________
Date of Birth: _____/____/____
Mailing Address:___________________________________________________________________________________________
Street
City
State
Zip
E-Mail Address: _________________________________________________
Height:___________________ Weight:___________________
In case of emergency notify:__________________________ Relationship_________________ Phone___________________
Will be available for employment (Give exact dates): From: _______________________ To: ________________________
P
& D
B
A
F
OSITION
EPARTMENT
EING
PPLIED
OR
Please indicate your first three preferences using 1, 2, and 3. If hired, camp management reserves the right to re-assign staff.
R=Camp Raymond, G=Camp Geronimo
Scout Staff (Age 16-17)
Counselor in Training (Age 14-15)
Archery
Health Lodge
Spade Ranch
(G) (Age 16+)
Aquatics
Nature
Climbing
(R) (Age 16+)
Climbing Tower
Outdoor Skills
Trading Post
(G) (Age 16+)
Commissioner
Project COPE
Wranglers
(R) (Age 16+)
(G)
Handicraft
Rifle Range
Other __________________
(includes Muzzleloading)
Headquarters
Shotgun Range
(R)
S
E
COUTING
XPERIENCE
Currently Registered in: Unit Type:
Troop Team Crew Ship
Unit Number: ____________
(Check one)
Current Leadership Position: ________________________________________________________________________________
Highest Rank/Award obtained as Cub Scout: _______________ Boy Scout: ____________ Venturer: ____________
Number of years as: Cub Scout : _____
Boy Scout: _____
Varsity Scout: _____
Venturer: _____
List Merit Badges Earned to Date:
1. ____________
6. ____________
11. ___________
16. ___________
21. ___________
2. ____________
7. ____________
12. ___________
17. ___________
22. ___________
3. ____________
8. ____________
13. ___________
18. ___________
23. ___________
4. ____________
9. ____________
14. ___________
19. ___________
24. ___________
5. ____________
10. ___________
15. ___________
20. ___________
25. ___________
Are you a member of the Order of the Arrow? Yes No
Ordeal
Brotherhood Vigil
E
& C
DUCATION
ERTIFICATIONS
Highest Grade Completed:________________
School:_________________________________________________________
CPR Certification? Yes
No
Date of Expiration _______________________
Aquatics Certification? Yes No
Certifying Organization: ___________________ Date of Expiration___________
Are you Licensed to Drive a Motor Vehicle? Yes No License No. __________Exp. _______ Insured? Yes No
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