www.glaacbsa.org (213) 413-4400 An Equal Opportunity Employer The Greater Los Angeles Area Council, Boy Scouts of America, is an equal opportunity employer. The Greater Los Angeles Area Council does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex, sexual orientation, sexual identity, marital status, disability, military status, or unfavorable discharge from military service. I agree to abide by the Charter, Bylaws, and Rules and Regulations of the Boy Scouts of America. Applicants are not required to give any information on this form that is prohibited by federal, state, or local law. All camp staff members must be registered members of the Boy Scouts of or become registered members of the Boy Scouts of America before employment begins. Position Applying For: Name: Home Address Email: Age 18 or older? Yes No Over 21? Yes No Relative employed by the council? Yes No Desired start date: If relative employed, name: Have you ever been employed by the council? No If so, when? How were you referred to the council? If by an individual and/or organization, give the name: List all specialized skills and training applicable to the position for which you are applying. Education (Attach information about other degrees or diplomas earned or in progress on a separate sheet. Also include technical or business training.) Highest Degree: GPA: Graduated: Yes No Major: School: Location: 2333 Scout Way, Los Angeles CA 90026 1
Prior Work Experience Include any employment prior to today s date, even if that employment has not ended. For more than two employers, submit the information in the same format on another sheet. Include military experience as if an employer, including branch, rank, and date of discharge. Last Employer: May we contact your current employer? Yes No Address: Supervisor Name: Start Date: End Date: Ending Pay Rate: per (Date format: mm/dd/yyyy) Ending Position or Rank: Duties: Reason for Leaving: Previous Employer: Address: Supervisor Name: Start Date: End Date: Ending Pay Rate: per (Date format: mm/dd/yyyy) Ending Position or Rank: Duties: Reason for Leaving: Have you ever been terminated or asked to resign from any job? Yes No If so, give details on a separate sheet. For which Camp you would like to apply Cherry Valley Camp Trask Holcomb Valley Forest Lawn Firestone Cabrillo Log Cabin Apply to All Boy Scout/Youth Experience: Council: Unit Number: No. of Years Tenure as Youth: Adult: Offices Held: Achievements: Special Training Completed: Why do you want to be on Camp Staff? 2333 Scout Way, Los Angeles CA 90026 2
Camping Experience Summer Camps: Greater Los Angeles Area Council Application for Employment Camp Years Camp Years High Adventures National Jamborees Camp Years Camp Years Staff Experience Camp Position Years Camp Position Years Camp Position Years Order of the Arrow (Circle one): Ordeal Brotherhood Vigil Availability (List dates available for work between June 1st and August 15 th for summer camp) Experience ( if earned merit badge OR if experience in area) Aquatics Swimming MB Lifesaving MB Rowing MB Canoeing MB Lifeguard BSA Red Cross Lifeguard Red Cross WSI Red Cross Lifeguard Inst. NCS Aquatics Supervisor NCS Aquatics Director COPE/Climbing COPE Participant COPE Instructor Rappelling Participant Rappelling Instructor Climbing MB Rock Climbing Instructor NCS COPE NCS Climbing Ecology/Nature Archeology MB Astronomy MB Electricity MB Energy MB Environmental Science MB Fish & Wildlife MB Fishing MB Forestry MB Geology MB Insect Study MB Mammal Study MB Nature MB Oceanography MB Reptile/Amphibian MB Soil & Water Con. MB Space Exploration MB Weather MB NCS Ecology/Con. Equestrian Horsemanship MB English Riding Roping Jumping Jousting Riding Lesson Instructor Food Service Dishwasher Assistant Cook Cook Food Service Management Handicrafts Basketry MB Leatherwork MB Indian Lore MB Woodcarving MB Pottery MB Newsletters Journalism MB Photography MB Yearbook/Newsletter Editor Outdoor Skills Backpacking MB Camping MB Cooking MB Hiking MB Metalworking MB Orienteering MB Pioneering MB Wilderness Survival MB Leave No Trace Instructor NCS Outdoor Skills Shooting Sports Archery MB Rifle MB Shotgun MB Black Powder Experience NRA Hunter Safety Inst. NCS Shooting Sports Misc. Cit. in the Nation MB Cit. in the World MB Communications MB Golf MB Equestrian MB Camp Management NCS Camp Management NCS Camp Commissioner NCS Program Director NCS Chaplaincy Program Bugling Music Voice Instruments Public Speaking Theater Song Leading Campfires Ceremony Teams Computer Literacy Computer MB Databases Spreadsheets Word Processors Networks Windows Macintosh Medical/Health First Aid MB Emergency Prep MB First Aid Certification First Aid Instructor CPR Certification CPR Instructor LPN RN EMT B I P Medical Student Year M.D. Special Training Junior Leader Training (JLT) Boy Scout Leader Training Wood Badge Mechanical/Trade Skills Tractor Operation Carpentry Experience Plumbing Experience Electrical Experience 2333 Scout Way, Los Angeles CA 90026 3
List in rank order of preference for your top four choices for positions. CAMP MANAGEMENT Min. Age Camp Director* 25 Assistant Camp Director* 21 Program Director* 21 Camp Commissioner* 18 OFFICE STAFF Business Manager 21 Health Officer (EMT-B minimum) 21 Chaplain 18 Data Entry/Office Clerk 15 AQUATICS Aquatics Director* 21 Waterfront Director* 18 Pool Counselor 18 Aquatics Instructor 15 CLIMBING Tower Director* 21 Tower Counselor 18 Tower Instructor-in-training 16 ACE ACE Director 21 ACE Counselor 18 ACE Instructor-in-training 16 EQUESTRIAN Head Wrangler 21 Wrangler 18 Assistant Wrangler 15 HANDICRAFT Min. Age Handicraft Director 18 Handicraft Instructor 15 HEALTH Health Director 18 Health Instructor 15 ISLAND ADVENTURE I/A Director 18 I/A Instructor 15 ECOLOGY/NATURE Nature Director 18 Nature Instructor 15 OUTDOOR SKILLS Outdoor Skills Director* 18 Outdoor Skills Instructor 15 SHOOTING SPORTS Rifle Director* 21 Shotgun Director* 21 Archery Director 18 Archery Instructor 15 TRADING POST Trading Post Manager 21 Trading Post Clerk 15 MISCELLANEOUS Day/Camp Staff min age 15 Trail to Eagle Instructor min age 15 Weekend Staff min age 15 FOOD SERVICE Min. Age Food Service Manager 21 Head Cook 21 Cook 18 Dining Hall Steward 18 Food Service Staff 15 SUPPORT STAFF Assistant Ranger 18 Quartermaster 18 Weekly Commissioner (Volunteer) 18 Counselor in Training (Volunteer) 14 1 st Choice: 2 nd Choice: 3 rd Choice: 4 th Choice: Mark your choice here: References 1 Give the names of three persons not related to you whom you have known for at least three years. Name Address, Phone, Email Company Years Acquainted 2 3 2333 Scout Way, Los Angeles CA 90026 4
Applicants are subject to background investigations, including criminal background checks. Offers of employment are conditional and subject to the applicant passing background investigations including criminal background checks. In compliance with federal law, all persons hired will be required to verify their identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Please read carefully before signing: I attest with my signature below that I have given the Greater Los Angeles Area Council, Boy Scouts of America, true and complete information on this application. No requested information has been concealed. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that the results of any investigation may be disclosed to other employees involved in the hiring process and I consent to the dissemination of the results of any investigation to such employees. I authorize the Greater Los Angeles Area Council, Boy Scouts of America, to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will result in the denial of employment or immediate dismissal. I understand that I will be required to submit a separate authorization form to the Greater Los Angeles Area Council, Boy Scouts of America authorizing the Greater Los Angeles Area Council, Boy Scouts of America to obtain the foregoing information. I understand that the relationship between the Greater Los Angeles Area Council, Boy Scouts of America and me is referred to as employment at will. This means that my employment can be terminated at any time for any reason, with or without cause, with or without notice, by the Greater Los Angeles Area Council, Boy Scouts of America or me. No representative of the Greater Los Angeles Area Council, Boy Scouts of America has authority to enter into any agreement contrary to the foregoing employment at will relationship. Nothing contained in this application creates an express or implied contract of employment. This application is current for 45 days. At the conclusion of that time, if I have not heard from the Boy Scouts of America, Greater Los Angeles Area Council and still wish to be considered for employment, it will be necessary to complete a new application. I certify, under penalty of perjury, that all of the above information is true and complete, and I understand that any falsification of omission of information may result in denial of employment or, if hired, may result in my termination from employment Signature Date Print Name I am the parent or legal guardian of the individual who is applying for employment in this application. I authorize the individual who is applying for employment with this application to submit an application to the Boy Scouts of America, Greater Los Angeles Area Council. Parent s signature if Applicant is under 18 : Return this application to: Attn: Gracie Peralta or Heather Endo 2333 Scout Way, Los Angeles, CA 90026 or Email: gracie.peralta@scouting.org / Estela.Chicas@scouting.org 2333 Scout Way, Los Angeles CA 90026 5