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Park Shore Country Day Camp Employee Application

Thank you for your interest in employment at Park Shore Country Day Camp. Please fill out the following information. We will contact you to set up an interview as soon as we receive your completed application. We look forward to meeting you and sharing all the excitement Park Shore Country Day Camp has to offer.

Please Fill Out & Complete All Fields or click here to Download an Application to Print and Fax to us

Application for Day Camp Employee Position

Personal & Contact Information

First Name:

Last Name:

Social Security#:

Street Address:

City:

State:

Zip Code:

Home Phone:

School Name:

School Address:

College Phone:

Cell Phone:

Email Address:

Birthdate:

Marital Status:

Gender:

Educational Background

High School:

Graduation Date:

College 1:

Graduation Date:

Major(s):

College 2:

Graduation Date:

Major(s):

Grad / Professional School:

Graduation Date:

Major(s)/Degree(s):

Current School Year:

Employment History

Most Recent or Current Position

Name of Business:

From:

To:

City & State:

Supervisor:

Weekly Salary:

Positions:

Telephone #:

Reason for Leaving:

2nd Most Recent Position

Name of Business:

From:

To:

City & State:

Supervisor:

Weekly Salary:

Positions:

Telephone #:

Reason for Leaving:

3rd Most Recent Position

Name of Business:

From:

To:

City & State:

Supervisor:

Weekly Salary:

Positions:

Telephone #:

Reason for Leaving:

Experience With Children

Please list all experience with children in school, clubs, etc.

Camp Experience

Please list all camp experience as both an employee and/or a camper.

Most Recent Position

Name of Camp:

Years Employed:

Supervisor:

Weekly Salary:

Positions:

2nd Most Recent Position

Name of Camp:

Years Employed:

Supervisor:

Weekly Salary:

Positions:

3rd Most Recent Position

Name of Camp:

Years Employed:

Supervisor:

Weekly Salary:

Positions:

Extra Curricular Activities

Please list the extra-curricular activities (sports, theatre, etc) in which you are or have been involved with. Kindly include hobbies and/or community service.

High School Activities

College Activities

Credentials & Certificates

First Aid:

Standard First Aid:

Yes

First Aid For Coaches:

Yes

Responding To Emergencies:

Yes

Water Safety Instructor:

Yes

Nassau County Lifeguard Certification:

Yes

American Red Cross Lifeguard Training:

Yes

CPR:

Community CPR:

Yes

CPR For The Professional Rescuer:

Yes

Training In The Use Of A Defibrillator:

Yes

Commercial Driver License:

Yes

If you have any of the above certifications, please list the expiration dates.

Park Shore Day Camp Experience

What Would You Like to Do At Camp?

If you are hired to work in a group, what is your preference? (Please place your choices in order from most desired to least desired.) We will try our best to follow the order you select, however, please understand there is no guarantee.

List any camp aged children you may have, indicate their names, genders, and ages:

If you were referred to Park Shore by someone please list his/her name and your relationship:

Any obligations requiring time away from camp?

References

Please do not use family members or friends as references. We would like objective recommendations from all references. Please include name, address, phone number, and relationship.

Reference 1:

Reference Name:

Reference Email:

Reference Address:

Reference Phone:

Relationship:

Reference 2:

Reference Name:

Reference Email:

Reference Address:

Reference Phone:

Relationship:

Reference 3:

Reference Name:

Reference Email:

Reference Address:

Reference Phone:

Relationship:

Background History

Have you ever been arrested, indicted, or convicted for any of the following:
Please answer all.

Child Abuse:

Yes

Sexual Abuse:

Yes

Drug Possession:

Yes

DWI:

Yes

DUI:

Yes

If yes to any of the above, please be specific as to the dates, reasons, and outcomes.

NOTE: ALL EMPLOYEES UNDER 18 YEARS OF AGE WILL ALSO BE REQUIRED TO SUBMIT VALID WORKING PAPERS. (NOTE: THIS IS A NYS LAW)
ALL EMPLOYEES UNDER 21 YEARS OF AGE MUST HAVE A BIRTH CERTIFICATE ON FILE IN OUR OFFICE. (OUR OFFICE WILL MAKE A COPY)

By clicking on the submit button you are in essence providing your signature and certify that all the information provided on this application is true and free of falsehood as well as giving the permission to conduct a background check. In the event that the applicant is hired, the terms of this application shall be incorporated into and become part of your employment agreement.

I Agree To The Terms Above

Day Camp & Educational Associations

Business Associations

The Premier Long Island Day Camp

Family Owned & Operated Since 1959

For Boys and Girls Ages 2 - 14

450 Deer Park Road
Dix Hills, Long Island New York 11746
Phone: 631.499.8580 · Fax: 631.499.6917

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Park Shore Country Day Camp Employee Application

Application for Day Camp Employee Position

Personal & Contact Information

Educational Background

Employment History

Most Recent or Current Position

2nd Most Recent Position

3rd Most Recent Position

Experience With Children

Camp Experience

Most Recent Position

2nd Most Recent Position

3rd Most Recent Position

Extra Curricular Activities

High School Activities

College Activities

Credentials & Certificates

First Aid:

CPR:

If you have any of the above certifications, please list the expiration dates.

Park Shore Day Camp Experience

What Would You Like to Do At Camp?

If you are hired to work in a group, what is your preference? (Please place your choices in order from most desired to least desired.) We will try our best to follow the order you select, however, please understand there is no guarantee.

List any camp aged children you may have, indicate their names, genders, and ages:

If you were referred to Park Shore by someone please list his/her name and your relationship:

Any obligations requiring time away from camp?

References

Reference 1:

Reference 2:

Reference 3:

Background History

Have you ever been arrested, indicted, or convicted for any of the following:Please answer all.

If yes to any of the above, please be specific as to the dates, reasons, and outcomes.

NOTE: ALL EMPLOYEES UNDER 18 YEARS OF AGE WILL ALSO BE REQUIRED TO SUBMIT VALID WORKING PAPERS. (NOTE: THIS IS A NYS LAW) ALL EMPLOYEES UNDER 21 YEARS OF AGE MUST HAVE A BIRTH CERTIFICATE ON FILE IN OUR OFFICE. (OUR OFFICE WILL MAKE A COPY)

Day Camp & Educational Associations

Business Associations

The Premier Long Island Day Camp

Family Owned & Operated Since 1959

Have you ever been arrested, indicted, or convicted for any of the following:
Please answer all.

NOTE: ALL EMPLOYEES UNDER 18 YEARS OF AGE WILL ALSO BE REQUIRED TO SUBMIT VALID WORKING PAPERS. (NOTE: THIS IS A NYS LAW)
ALL EMPLOYEES UNDER 21 YEARS OF AGE MUST HAVE A BIRTH CERTIFICATE ON FILE IN OUR OFFICE. (OUR OFFICE WILL MAKE A COPY)