Education - Please list  any degrees that you currently hold or are working on:

1.    2.

Work History - Starting with your most recent employer, please provide us with the name, phone number, position and dates of employments for your past three employers:

Name                                                                                    Phone Number                  Position                                       Employment Dates

Please indicate the type of Camp experience you have:

Please let us know (if any) what types of certifications you have:

References - Please provide us with the name, phone number, and relationship of 3 people who have knowledge of your skill level, personality, and work ethic, and who will be willing to send us a letter of reference to the above address:

Name                                                                                    Phone Number                                Relationship

Please answer thoughtfully the following questions:

What contributions do you think that you can make to Camp Talooli?

What contributions do you think a well run camp can make to children?

Do you have any impairments, physical or mental, which would interfere with your ability to perform the job

for which you have applied? If so, explain:

    Give us a brief biographical sketch, including specialized training in camping, and experience and/or training in other fields which might

have a bearing on the position(s) for which you are applying:

Voluntary Disclosure Section:

Have you ever been convicted of a crime(s) other than a minor traffic offense?    yes   no                             

A prior conviction will not necessarily bar you from employment. The type and recency of the conviction will be considered by the camp.

Have you ever been convicted of a crime in which a child was the victim?   yes   no

Have you ever been criminally charged with any crime related to the mistreatment, abuse or molestation of children?   yes   no                                                                                                               

BY PUTTING YOUR NAME IN THE BOX BELOW AND SUBMITTING THIS APPLICATION YOU ARE STATING THAT THE INFORMATION PROVIDED ON THIS FORM IS TRUTHFUL AND ACCURATE AND WILL BE CONSIDERED A PART OF ANY CONTRACT I ENTER INTO FOR EMPLOYMENT AT CAMP TALOOLI

Applicant Signature (enter your full name)