Camp Discovery 2014 Volunteer Staff Application

Submission Deadline: April 11, 2014

Personal information

First Name:  
Middle Name:
Last Name:  
Other names by which known (i.e. maiden name):
Gender:  
Date of Birth: (mm/dd/yyyy)  
Home Address:  
City:  
State:  
Zip:  
Primary Phone:  
Email:
How did you find out about Camp Discovery?
Do you have a skin condition?

Work / School

Current Employer or School:  
Address:  
City:  
State:  
Zip:  
Phone:
Type of Work:

Camp you are applying for:






Please note that you may be required to arrive one day early for orientation.

Position you are volunteering for:








Tell us about your medical training if applicable:

Additional Information

Please describe your abilities and motivations that you believe will make you a valued member of the volunteer staff at Camp Discovery.
 
Do you have any experience in supervising and working with children? Explain.
 
Do you have any particular skills, training or expertise that could be incorporated into a camp activity?
 
What expectations do you have for your time at camp and what would you like to get out of the week?
 

References

Please list three adult references that are not direct family members or friends. Appropriate references are teachers, supervisors, employers, or other authority figures that can attest to your degree of maturity and responsibility and your ability to work as a team player.
Reference 1
Name:  
Relationship:  
Phone Number:  
Email:
Reference 2
Name:  
Relationship:  
Phone Number:  
Email:
Reference 3
Name:  
Relationship:  
Phone Number:  
Email:

Letter of Reference

Please attach one letter of reference below, or send the letter to Janine Mueller:
Address:
Janine Mueller
American Academy of Dermatology
930 E Woodfield Rd
Schaumburg, IL 60173
Fax:
(847) 330-8907
Email:
jmueller@aad.org

Attach letter:

Disclosure

Do you use illegal drugs?
Have you ever been convicted of a criminal offense?
Have you ever been charged with child abuse or neglect?
Has your driver's license ever been suspended or revoked?
Is there any other circumstance involving you or your background that would call into question your being entrusted with the supervision, guidance, and care of young people?

Conditions

 
  • I must attend the orientation session.
  • I authorize the American Academy of Dermatology/Camp Discovery to conduct background checks and reference checks.
  • I will not be allowed to smoke on camp grounds.
  • The use of alcohol or any illegal drugs will be strictly forbidden.
  • I will abide by all American Academy of Dermatology policies or risk being sent home at my own expense.

A representative of Camp Discovery will contact you for additional information.