Date Received:__________________
Camp Perkins Northwest Texas Council, BSA Junior Staff Application
******ALL APPLICANTS WILL BE INTERVIEWED***** A STAFF MEMBER MUST: 1. Be a registered member of the Boy Scouts of America 2. AGE—be between 14 and 20 years of age, First Class Scout or Venture Crew Member 3. Exemplify the ideals of Scouting as expressed in the Scout Oath and Law (Print in Full) Last First Middle Initial
Name:______________________________________ Date of Application:_____________ Address____________________________________________________________________ City_______________________________ State_____________ Zip____________________ Best Contact Phone #______________________ Email:_____________________________ Social Security Number____________________ Date of Birth________________________ Troop/Crew # __________ Age__________ Rank________________ Physical Limitations (if any) __________________ (As a condition of employment, all applicants must complete a BSA Class A, B, C physical
T-Shirt Size ___S ___M ___L ___XL ___XXL ___ XXXL
Positions For Which I am Applying: Rank in Order of Choice ___Aquatics ___Handicraf t ___Personal Fitness ___STEM Programs
___Asst. Ranger ___Nature ___Shooting Sports ___1st Year Camper Program
___Dining Hall ___Outdoors ___Specialties ___ Other
RETURN YOUR COMPLETED APPLICATION TO:
Northwest Texas Council 3604 Maplewood Ave Wichita Falls, TX 76308 Deadline: February 28, 2015
WHY DO YOU WANT TO BE A MEMBER OF CAMP STAFF?
Please list any qualifications for serving as a staff member at camp.
Please list any special talents or hobbies you have that will be an asset at camp (i.e. storytelling, playing an instrument, singing, first aid training, skit performing) ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ All Staff will participate in skits, songs and campfire activities. Remember this when applying. REFERENCES: One needs to be your current Scoutmaster/Crew Advisor
(ADULTS; NOT PARENTS OR
RELATIVES) INCLUDING PREVIOUS EMPLOYER.
Name_________________ Address__________________ Phone_____________ Relationship___________________ Name_________________ Address__________________ Phone_____________ Relationship___________________ Name_________________ Address__________________ Phone_____________ Relationship___________________ Details 1) Staff will be working for weeks, this includes staff training, Boy Scout Summer Camp, Cub and Webelos Resident Camp. 2) Camp preparation and training will be done during scheduled training dates as well as Staff Training 3) Working hours will fluctuate and are based on the needs of our campers. The NWTC and its staff (both professional and volunteer) strictly adhere to the child labor laws set forth by the State of Texas. You will be given the appropriate amount of time off as required. 4) Actual hours worked should be no more than 40 hours per week.
I understand that by signing this application I consent to residing at Camp Perkins during the term of my contract should I be offered a Camp Staff position. I understand that I will be required to conduct myself in accordance with the Scout Oath and Law and will wear the official Boy Scout uniform or other appropriate uniform as designated by the Camp. I understand that as a condition of employment at Camp Perkins that all laws applicable in the Commonwealth of Texas will be enforced, including but not limited to the use of tobacco products, alcohol, and any illegal substances. I am in good physical condition and, if employed, will provide an up-to-date physical examination prior to beginning employment. If employed, I understand that I will be required to be a registered member of the Boy Scouts of America and will support its policies and programs. National BSA policy requires us to conduct a background check of all potential employees before hiring. Date:______________ Applicant’s Signature:___________________________________ Parent’s Signature:__________________________________________________________ (For applicants under 18 years of age) Mail to: Larry Petersen Camp Director Camp Perkins, BSA 3604 Maplewood Wichita Falls, Texas 76308
Fax to: Larry Petersen Camp Director Camp Perkins, BSA 940-691-0920
************Do Not Write Below: Camp Director purposes only*********** ___________________________________________________________________________________________________________ _____________________________________________________________________________________________
Position Hired For____________________________ Area
Special Talents______________________________
_______________ Position
