Camp Staff Application BASIC PERSONAL INFORMATION

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Dan Beard Scout Reservation 2018 Boy Scouts of America Camp Staff Application BASIC PERSONAL INFORMATION Current Date Name (Last) (First) Date of Birth Address City State Zip Home Phone( ) Cell Phone( ) Email Parent Email COLLEGE ADDRESS: Address: City State Zip Expected last date of college residence (for mailing purposes) Troop/Team/Crew# Council Length of Time as a Scout (BSA, AHG, GSUSA) Length of Time as an Adult Scouter Scout Rank Current Scout Position Are you currently registered with the BSA? Yes No Order of the Arrow? Ordeal Brotherhood Vigil BSA Membership ID: Scouting Positions Held or Leadership Training: Wood Badge NYLT Boy Scout Leader Training Scouter s Key Award Senior Patrol Leader Other (please specify) CAMP PREFERENCE Camp Friedlander Cub World Community/Day Camp No Preference POSITION PREFERENCE: I am interested in the following position(s). They are listed in the order of my preference. 1. 2. 3. 4. Applicants are considered for all positions without regard to race, color, sex, national origin, age, marital status or veteran status, or the presence of a health problem or handicap that is unrelated to the person s ability to perform the job assigned. I will meet the minimum age requirement by June 3, 2018. Yes No (See page 5 for age requirements.) ALL EMPLOYEES SHOULD BE AVAILABLE FOR THE FULL SEASON (June 3 through August 6, 2018) Exceptions must be requested during the employment interview.

WHY DO YOU WANT TO WORK AT CAMP? EXCERPT FROM DECLARATION OF RELIGIOUS PRINCIPLE (from Adult Membership Application): The Boy Scouts of America maintains that no member can grow into the best kind of citizen without recognizing their obligation to God and, therefore, acknowledges the religious element in the training of the member, but it is absolutely nonsectarian in its attitude toward the religious training. It is policy that the organization or institution with which the member is connected shall give definite attention to their religious life. Only persons willing to agree with this declaration of principle and the Bylaws of the Boy Scouts of America shall be entitled to certificates of leadership. Do you agree with the declaration of principle? Yes No Are you permitted to become lawfully employed in the U.S? Yes No (Proof of citizenship required) Have you ever been convicted of a felony? Yes No (You may answer No if your conviction has been ordered sealed, expunged, or eradicated.) NOTE: Conviction of a crime is not an automatic bar to employment. All circumstances will be considered, including what you were convicted of and how long ago the conviction occurred. Please provide complete information about the conviction on a separate sheet of paper.) SIGNATURES I understand that if employed on the council camp staff, I will be required to become a registered member of the Boy Scouts of America (all applications to the BSA are required to give permission to a background check), purchase required uniforms, and to have a current (within one year) medical examination. Further, I hereby certify that the answers and other information on this application are true and correct and that I understand that any misrepresentation or conscious omission of facts on my part will be justification for dismissal, if employed. Signature Date PARENT S APPROVAL (if under 18) SCOUTMASTER S APPROVAL (if under 18) Mail completed application to: Dan Beard Council 10078 Reading Road Cincinnati, OH 45241 Email: camping@danbeard.org Web: www.danbeard.org/camp Phone: 513-577-7700 Date of Interview Interviewed by Considered for HIRED FOR CAMP: SALARY: APPROVAL:

SUMMER CAMP EXPERIENCE (where & year(s)) CAMP STAFF EXPERIENCE (position, area & year(s)) Number of Years on DBSR Staff (list years): COLLEGE/SCHOOL/EXPERIENCE Name of College/School Grade Average Grade Completed Course of Major Extracurricular Activities (list) Leadership Positions (list) OTHER LEADERSHIP EXPERIENCES Position (List) Responsibilities (List) REFERENCES REQUIRED (provide all information requested): Adult Member of Unit, College Official, or Current Employer: Address: City: State Zip Position/Title: Email: Community Leader (youth leader, religious leader, civic leader, etc): Address: City: State Zip Position/Title: Email: Teacher, Supervisor, or Associate: Address: City: State Zip

Position/Title: Email: Please check the areas where you have experience (merit badge or other) AQUATIC EXPERIENCE Canoeing Kayaking Lifesaving Rowing Swimming Small-Boat Sailing Lifeguard BSA Red Cross Basic Rescue Water Safety Instructor Red Cross Advanced Lifesaving CPR Training (date) CPR Instructor (date) National Camping School Aquatics Sommers Canoe Base Expedition NATURE/ECOLOGY/SCIENCE/TECH Astronomy Environmental Science Chemistry Fishing/Fly Fishing Engineering Geocaching Oceanography Nuclear Science Robotics Space Exploration National Camping School-Ecology/Conservation HANDICRAFT Art/Animation Movie Making Photography OUTDOOR SKILLS Camping First Aid Pioneering Search & Rescue Chess Journalism Pottery/Sculpture Emergency Preparedness Landscape Architecture Soil & Water Conservation Wilderness Survival Wood Carving Game Design High Adventure Expedition National Camping School-Outdoor Skills (ODS) or 1 st -Year Camper Training COPE & CLIMBING Climbing COPE Participant Climbing Instructor NCS Trained (Yes/No) (date) COPE Instructor NCS Trained (Yes/No) (date) SHOOTING SPORTS Archery Rifle Shooting LIFE SKILLS Communications Public Speaking Shotgun Shooting NRA Hunter Safety Cooking Fire Safety National Camping School) (date) Other Traffic Safety Personal Fitness Signs, Signals, and Codes TRADE/MAINTENANCE/CLERICAL Automotive Maintenance Carpentry Experience Home Repairs Electrical Experience Welding Plumbing Experience Tractor Operation Office/Clerical Experience Retail/Sales Experience Food Service Experience Chaplaincy CULTURAL VILLAGE Archeology Basketry Leather Work PROGRAM Song Leading Music and Bugling Citizenship in the Nation Citizenship in the World Scouting Heritage Campfires Leading Games Indian Lore & American Culture American Heritage MEDICAL Medical Student Paramedic: exp EMT; exp Physician Advanced First Aid Certificate: exp CPR Training exp Nursing: Student LPN RN

POSITIONS (Positions exist at both camps unless otherwise noted; CF=Camp Friedlander, CW=Cub World, CC=Community Camp, R=Reservation): Minimum Age 21 Minimum Age 18 Minimum Age 16 (CF) or 15 (CW) * Camp Director Program Director Commissioner Business Manager (R) Chaplain Health Officer/Medic ACE Director (CF) Aquatics Director (R) Climbing Director (CF) COPE Director (CF) Shooting Sports Director (R) Rifle Director (CF) Shotgun Director (CF) Trading Post Manager Community Camp Team Lead (CC) Assistant Commissioner ACE Staff (CF) Archery Director BB Range Director (CW) COPE/Climbing Staff (CF) Cultural Village Director (CF) Dining Hall Director Handicraft Director (CF) Handyman Director (CF) Lake/Pool Director Life Skills Director (CF) Marketing Director (R) NEST Director (CF) Office Manager Outdoor Skills Director (CF) Ranger Staff (R) Theme Area Director (CW) ** (Specify in preference section) Trailblazer (First Year Camper) Director (CF) Shooting Sports Staff Aquatics Staff Cultural Village Staff (CF) Dining Hall Staff Handicraft Staff (CF) Handyman Area Staff (CF) Life Skills Staff (CF) NEST Staff (CF) OA Camp Chief (CF) Office Staff Outdoor Skills Staff (CF) Quartermaster (R) Trading Post Staff Theme Area Staff (CW) ** (Specify in preference section) Trailblazer (First Year Camper) Staff (CF) Community Camp Program Staff (CC) *14 year olds may serve as Counselors-In-Training (CIT) at Cub World. *14 and 15 year olds may serve as Counselors-In-Training (CIT) at Camp Friedlander. Please reference the separate CIT Application. **Cub Scout Theme Areas are Fort (Wolves, ages 6 & 7), Castle (Bears, ages 7 & 8), Mountain Man Village (1 st year Webelos, ages 8 & 9), and Miner s Camp (2 nd year Webelos, ages 9 & 10)