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POSITION APPLYING FOR____________________________________________________________
LOCATION__________________________________________________________________________
NAME______________________________________________________________________________
ADDRESS___________________________________________________________________________
____________________________________________________________________________________
PHONE #_______________ALTERNATE# ______________E-MAIL ADDRESS__________________
EDUCATIONAL BACKGROUND_______________________________________________________
____________________________________________________________________________________
PRESENT GOALS____________________________________________________________________
____________________________________________________________________________________
FIRST AID CERTIFICATION___________________________________________________________
HEALTH & PHYSICALCONDITION_____________________________________________________
AVAILABILITY (When could you start? How long will you work?)______________________________
____________________________________________________________________________________
EXPERIENCE WITH ELEMENTARYCHILDREN__________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
EXPERIENCE WITH CAMPING, HIKING, NATURE STUDY,ETC.___________________________
____________________________________________________________________________________
____________________________________________________________________________________
ABILITIES & EXPERIENCE IN MUSIC: vocal_____________________________________________
instrumental__________________________________________________________________________
ABILITIES & EXPERIENCE IN GROUP GAMES/FREE TIME ACTIVITIES_____________________
____________________________________________________________________________________
____________________________________________________________________________________
DISCIPLINE (what methods work for you)_________________________________________________
____________________________________________________________________________________
INTERGROUP RELATIONS (experience with ethnic diversity)_________________________________
____________________________________________________________________________________
APPLICANT OVERALL EVALUATION OF YOUR SUITABILITY FOR THIS JOB (circle one):
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