Counselor Application

Personal Information

First Name *(Please use you legal name so that we can pay you)

Last Name

Preffered Name(If different from above)

Email Address *

Phone *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal code *

Country *

Date of Birth *

Entering Grade(Leave blank if not in high school)

Parent/Guardian Name *

Parent/Guardian Email Address *

Parent/Guardian Phone *

Have you been a counselor at VerShare Camp before? *Yes, I am a returning Cosunselor!No, but I have been a CIT!No, this is my first time on staff!

Are you CPR Certified? *Currently CPR CertifiedCertification has expired but I’ve done the trainingNever been certifiedOther

Which age range would you like to work with? *Chipmunks (5-7)Bobcats (8-12)(Select one, or both)

References

Please give two references. At least one should be someone other than a relative (teacher, guidance counselor, or a family you babysit for, etc) Your references should be able to speak to your potential abilities as a CIT.

Reference #1

Name *

Email Address *

Phone *

Text *

Reference #2

Name *

Email Address *

Phone *

What is your relation to this person? *

Applicant Questionnaire

Please take a few moments to answer the following questions. The purpose of this questionnaire is to help you think about why you are interested in being a CIT and to give us the chance to get to know you better.

Why do you want to be a Counselor for VerShare Camp? What do you hope to gain from these experiences? *

What special qualities or skills would you contribute to the group? *

What do you enjoy most about working with children? *

Please describe a time when you were a good role model to a younger child. *

Please describe a difficult situation you’ve experienced when caring for a child and how you handled it. What would you have done differently? *

What is your previous camp experience? Have you been a CIT or Counselor before? (this camp or others) *

What is your previous experience in outdoor activities like hiking, boating, camping, etc. What do you enjoy about being outdoors? What do you find most challenging? *

In your opinion, what makes a good leader? *

Please let us know about your other interests & hobbies! *