Ohio  FFA  Camp  Muskingum   Nature’s  Classroom   3266  Dyewood  Road  SW   Carrollton,  OH  44615   330-­‐627-­‐2208   [email protected]  

     

An  Equal   Opportunity   Employer  

  Name   _____________________________________________________    Date  ________________________________________       Address    ___________________________________________________________________________________________________    

         Street  

 

 

 

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State  

 

 

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Phone    _____________________________________________________        Home        Cell        Other  _____________       Email    _____________________________________________________     Year-round Jobs at Camp How  did  you  hear  about  this  position?    ACA ________________________________________________________________        

Are  you  18  years  old  or  older?      Yes        No    

Present  or  Immediate  Past  Employment   Employer    _____________________________________________________      Job  Title  ________________________________   Address    ___________________________________________________________________________________________________              Street         City       State       Zip   Supervisor    _____________________________________________    Phone  Number  ________________________________   Job  Responsibilities  ______________________________________________________________________________________   _____________________________________________________________________________________________________________   Dates  of  Employment  –  From  ______________    To  _______________       Starting  Salary    _________    Ending  Salary  _________   Are  you  currently  employed?      Yes        No    If  No,  reason  for  leaving?    ____________________________   ______________________________________________________________________________________________________________   May  we  contact  them?      Yes        No    

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If  you  haven’t  done  so  already,  please  attach  a  copy  of  your  resume  to  this   application.    Please  make  sure  that  it  includes  other  past  employment  and   your  educational  background.

References   If  references  are  not  listed  on  your  resume,  then  please  list  three  references  that  are  unrelated  to  you.  

Name    _________________________________________________    Relationship  ____________________________________   Home/Cell  Phone    ____________________________________    Work  Phone    ___________________________________     Email    __________________________________________________    Years  Known  ___________________________________  

Name    _________________________________________________    Relationship  ____________________________________   Home/Cell  Phone    ____________________________________    Work  Phone    ___________________________________     Email    __________________________________________________    Years  Known  ___________________________________  

Name    _________________________________________________    Relationship  ____________________________________   Home/Cell  Phone    ____________________________________    Work  Phone    ___________________________________     Email    __________________________________________________    Years  Known  ___________________________________  

Please  Briefly  Answer  the  Following:   1.    What  strengths  do  you  have  that  in  your  opinion  would  contribute  to  a  successful  resident   outdoor  education  program?         2.    Have  you  worked  with  children  before  in  any  capacity?    What  age  group?    What  were  your   responsibilities?           3.    In  what  way  will  a  position  at  Nature’s  Classroom  assist  you  in  the  future?        

  4.    Check  below  the  areas  in  which  you  have  expertise:   ________  Zoology  

 

________  Math    

________  Botany  

 

________  Language  Arts  

________  Co-­‐Initiatives/Low  Ropes  

________  Geology  

 

________  History  

________  Large  Group  Games  

________  Weather  

 

________  Living  History  

________  Storytelling  

________  Social  Studies  

________  Song  Leading  

________  Water                                        

________  Conservation                              ________  Art   ________  Ecology  

 

 

________  Music    

 

 

________  Foreign  Cultures  

                         ________  Orienteering                              ________  Night  Hike  

________  Astronomy                            ________  Agriculture    

________  High  Ropes    

 

    Do  you  have  any  other  special  skills  or  qualifications  that  might  be  of  value  in  a  resident   outdoor/environmental  education  program?             Are  you  currently  First  Aid  and  CPR  Certified?    If  so,  when  does  the  certification  expire?  

Other  Information   This  section  contains  requested  information  needed  for  legally  permissible  reasons.  Please  answer  the  following   questions.  

1.  Are  you  prevented  from  lawfully  becoming  employed  in  this  country  because  of  visa  or  immigration   status?        Yes        No     2.    Have  you  been  convicted  of  a  felony  crime  within  the  last  7  years?      Yes        No     If  yes,  please  explain  _______________________________________________________________________________________________   _______________________________________________________________________________________________________________________   3.  Would  you  object  to  Ohio  FFA  Camps,  Inc.  checking  on  you  with  the  local  police  where  you  live  or   lived?       Yes        No       Signature    __________________________________________________________________________________________________________  

Employee  Conditions   I  understand  and  agree  to  the  following:   •   •

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Any  material  misrepresentation  or  deliberate  omission  of  a  fact  in  my  application  may  be  justification  for  refusal  of   employment,  or  if  employed,  termination  from  employment.    The  data  and  information  given  herein  are  true  and  complete   to  the  best  of  my  knowledge.   Ohio  FFA  Camps,  Inc.  will  make  a  thorough  investigation  of  my  entire  work  and  personal  history  and  may  verify  all  data   given  in  my  application  for  employment,  related  papers,  or  oral  interviews.    I  authorize  such  investigation  and  the  giving   and  receiving  of  any  information  requested  by  Ohio  FFA  Camps,  Inc.,  and  I  release  from  liability  any  person  giving  or   receiving  and  such  information.    I  understand  that  falsification  of  data  so  given  or  other  derogatory  information  discovered   as  a  result  of  this  investigation  may  prevent  my  being  hired,  or  if  hired,  may  subject  me  to  immediate  dismissal.   My  employment  may  be  terminated  by  Ohio  FFA  Camps,  Inc.  at  any  time  without  liability  for  wages  or  salary  except  such   as  may  have  been  earned  at  the  date  of  termination.   If  hired  I  will  be  working  with  people  from  many  different  economic,  religious,  intellectual,  racial,  and  ethnic  backgrounds   and  that  none  of  my  actions  will  intentionally  display  prejudice.    It  is  further  understood  that  different  groups  might  have   different  rules  and  regulations  governing  behavior,  and  that  I  need  to  be  flexible  in  this  area.   My  signature  below  declares  that  I  have  not  been  accused  or  convicted  of  child  abuse.    I  am  welcome  to  ask  for  clarification   as  to  why  this  statement  is  on  this  application.   If  hired,  there  will  be  a  trial  period  of  30  days  before  application  is  officially  accepted.    This  will  allow  time  for  Ohio  FFA   Camp  Muskingum  to  fully  review  my  records  and  job  performance.    I  will  be  paid  normal  salary  or  wages  for  this  period.     I  agree  to  a  fingerprint  test  by  local  law  enforcement  personal  selected  by  Nature’s  Classroom.    I  give  permission  to  obtain   a  copy  of  any  arrest  or  conviction  record  pertaining  to  me  now  on  file  of  the  Bureau  of  Criminal  Identification  and   Investigation.   I  further  understand  that  this  is  an  application  for  employment  and  that  no  employment  contract  is  being  offered.   I  understand  that  if  I  am  to  be  employed,  I  will  enter  into  an  agreement  of  terms  as  stated  by  the  Ohio  FFA  Camps,  Inc.   Employee  Contract  and  related  staff  training  statements  of  rules,  regulations,  and  guidelines.   This  application  for  employment  shall  be  considered  active  for  a  period  of  time  not  to  exceed  45  days.    Any  applicant   wishing  to  be  considered  for  employment  beyond  this  period  should  inquire  as  to  whether  or  not  applications  are  being   accepted  at  that  time.   The  Ohio  FFA  Camp  Muskingum  Director  and  its  Board  of  Directors  all  hold  the  right  to  determine  the  best  action  to  take   for  the  good  of  the  programs  and  Camp  operation.   I  have  read  and  understand  the  above  employee  conditions.  

  Signature  __________________________________________________   Date  ______________________________________