Counselor-In-Training Application

Transcription

1 Counselor-In-Training Application Position Description: Serving as a Camp Blue Hawk Counselor-In-Training (CIT) provides young adults, ages years old at the time of camp, the opportunity to get hands on experience working with children with diabetes in a camp setting. CIT s will have opportunities to grow in their communication, decision-making, and leadership skills in a fun and memorable environment. Serving as a CIT is seen as a pathway to becoming a full counselor. As such, CIT s will be paired with counselors throughout camp, assisting with leading campers in activities, addressing camper issues, and providing a safe space for campers to learn diabetes management, build relationships with peers, and have an unforgettable camp experience. CIT s are NOT campers, and will not be treated as such. Persons serving in this role must be mature, reliable, and trustworthy, as they will have responsibilities throughout camp. Additionally, CIT s with diabetes, must themselves practice good diabetes management, and be self-sufficient in doing so. CIT s who are selected and complete all requirements set forth by the Camp Blue Hawk Coordinator, will be provided a $ stipend for their service during the week of camp. Counselor-In-Training Qualifications: Must be years old at the time of camp. (July 19, 2017) Demonstrate compliance with his/her prescribed diabetes management plan as defined by their diabetes health care provider. Present evidence of social and emotional maturity, leadership potential, and a willingness to learn and comply with CIT program guidelines. Basic documentation includes: o One reference from a non-family member who has interacted with the applicant. o Responses on the CIT application form, and information gathered during the interview process. Preference may be given to applicants with previous Camp Blue Hawk experience. Successful passing of the University of Oklahoma background check for working with minors on campus. Application Process: Step 1: Complete and return the following Application and Reference Forms by 5:00 PM on March 31, You will be notified when your application has been received. Step 2: Your application will be reviewed and selections will be made. Notification of CIT selections will be made no later than April 14, Step 3: Those selected for the CIT position will be asked to attend Counselor Training Retreat scheduled for July 8, 2017 at the OU Health Sciences Center in Oklahoma City. Persons that cannot attend training may not be allowed to serve as a CIT. Please confirm your availability on this date prior to submitting your application.

2 Counselor-In-Training Application Applications are due by 5:00 PM on March 31, Applications that remain incomplete or are received after the deadline will not be considered. The CIT Application should be typed or neatly handwritten and submitted via to fax to ATTN: Camp Blue Hawk, or U.S. Mail to the address below. If you have any questions or concerns about the application please or call ext Harold Hamm Diabetes Center / Camp Blue Hawk Attn: Elvie Ellis 1000 N. Lincoln Blvd., Suite 1200 Oklahoma City, OK SECTION A: APPLICANT INFORMATION Applicant Last Name Applicant First Name Date of Birth Gender Address Address Primary Phone Number City State Zip Code Date diagnosed (mm/yyyy) Name of Your Medical Provider T-Shirt Size SECTION B: APPLICANT CAMP HISTORY Have you ever been a camper at a diabetes camp? (circle one) YES NO If yes, what was the name of the camp you attended? What was your favorite memory from that camp? Please list any other camps you have attended or worked at below, including position if applicable.

3 SECTION C: ABOUT YOU Why do you want to be a Counselor-In-Training for Camp Blue Hawk? What are your strengths, and how do you think they will help you be a successful CIT? Describe the leadership roles you have played with children, like babysitting, working with kids at your place of worship, caring for younger family members, etc. Describe something you ve done in the past year that you are proud of.

4 SECTION D: RECOMMENDATION Please give a copy of the Recommendation Form to someone who is not related to you. Your reference should know you well (more than a year) and have knowledge of your character, experience, and abilities. Recommendations should be sent directly by the endorser to the Camp Blue Hawk office when completed, and must be received by 5:00 PM on March 31, Name of Reference Relationship to Applicant Daytime Telephone # Address SECTION E: CIT AGREEMENT Please read the following items carefully. The applicant must initial each item in order for this section, and the application, to be considered complete. I understand that, if selected for a CIT position, I must participate in the Counselor Training Retreat on July 8, 2017 at the OU Health Sciences Center in Oklahoma City. I understand that, if selected for a CIT position, I must attend and fully participate in the entirety of Camp Blue Hawk (July 19, 2017 July 23, 2017), including staff training the day before camp starts (July 18, 2017), to receive the $ CIT Stipend. I understand that, if selected for a CIT position, I am responsible for transportation to and from Counselor Training and Camp. If selected for a CIT position, I agree to abide by Camp Blue Hawk camper and staff behavior expectations, serve as a role model for campers, and fulfill the CIT role to the best of my ability. I understand the goal of the Counselor-In- Training Program, and I am submitting this application to serve as a 2017 CIT. Printed Applicant Name Applicant Signature Date

5 Counselor-In-Training Recommendation Form Page 1 Applicant Name Recommender Name Date The above-named person has listed you as a personal reference for a Counselor-In-Training position at Camp Blue Hawk, a 5-day, 4-night summer camp serving children and teens living with type 1 diabetes. Please fill out and return these recommendation forms directly to the Camp Blue Hawk office via to CampBlueHawk@ouhsc.edu, fax to ATTN: Camp Blue Hawk, or U.S. Mail to the address below. Mailed recommendations must be received by 5:00 PM on March 31, If you have any questions or concerns about the application please CampBlueHawk@ouhsc.edu, or call ext Harold Hamm Diabetes Center / Camp Blue Hawk Attn: Elvie Ellis 1000 N. Lincoln Blvd., Suite 1200 Oklahoma City, OK Please check the box to the right that best describes the applicant s measure of the following attributes: Self-Discipline Willingness to Accept Instruction Adaptability Dependability/Responsibility Punctuality Conscientiousness/Common Sense Judgement Initiative Emotional Maturity Concern for Others Communication Outgoing Personality Leadership Potential Not Known Poor Below Average Average Above Average Excellent THIS FORM IS TO BE RETURNED DIRECTLY TO THE CAMP BLUE HAWK OFFICE

6 Counselor-In-Training Recommendation Form Page 2 Applicant Name Recommender Name Date How long have you known the applicant? In what capacity? What is the applicant s strongest asset? What is the applicant s biggest challenge? Have you directly observed the applicant s interaction with children younger than him/her? If so, please explain. Do you recommend the applicant for a CIT Position at Camp Blue Hawk, helping care for and teach children living with type 1 diabetes at an overnight summer camp? (check one): I HIGHLY recommend applicant. I recommend applicant. I do NOT recommend the applicant. Signature Date THIS FORM IS TO BE RETURNED DIRECTLY TO THE CAMP BLUE HAWK OFFICE