If you are interested in joining the Camp Kirk staff, simply complete and submit the form below and download the "Health & Reference Forms (PDF)" located on the right menu. The Health & Reference Forms can be completed and mailed to our office separately. If you prefer, you can download and complete the Staff Application Package, then mail it to the address on the form.

Contact Information

	First Name:*
	Last Name:*
	S.I.N.:*
	Email Address:

Current School Address

	Address:
	City
	Province:	Ontario Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Prince Edward Island Quebec Saskatchewan Yukon Territory
	Postal Code:
	Phone Number:
	Fax Number:

Current Home Address

	Address:
	City
	Province:	Ontario Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Prince Edward Island Quebec Saskatchewan Yukon Territory
	Postal Code:
	Phone Number:
	Fax Number:

Position

Positions(s) for which you are you applying, in order of preference. For example, place a (1) beside your first preference, a (2) beside your next preference, etc...   Tripping Guide and Campcraft Instructor   Support Staff   Program Staff - Activity Instructors   Cabin Counsellors   Camp Nurse/First Aider

Education

	Secondary School: Highest grade completed: What year? Type of certificate or diploma received:
	Community College: Highest grade completed: What year? Type of certificate or diploma received:
	University: Highest grade completed: What year? Major and Minor Subjects: Degrees, licenses or certificates received:

Employment

Present Employer (if applicable): How long have you been employed there? Current Position: Areas of Responsibility:

Previous Camping Experiences (As staff and/or camper)

Year: Name of Camp? Position: Year: Name of Camp? Position: Year: Name of Camp? Position:

Activities

Of all of the following activities, place a (1) beside the ones where you are qualified to instruct, a (2) beside the ones where you have a high degree of experience and a (3) beside the ones where you have the least experience. Swimming Camping Ecology Basketball Drama Sing-Song Leading Music C.P.R. Canoeing Archery Ropes Course Arts & Crafts Orienteering Fishing Carpentry C.P.I. Canoe Tripping Cooperative Games Climbing Wall Ceramics Campfire Programs Martial Arts First Aid Maintenance Please list your current and valid swimming qualification(s): (Red Cross & R.L.S.S.) With what age group would you prefer to work? Why? What work have you done involving children? What are your major strengths? What are your weaknesses? Have you ever worked with children who have learning disabilities?

Written References
Please distribute two (2) reference forms to whomever you choose, outside of family members, as character references. Preferably, you should chose a former Camp Director, Supervisor, Principal or Teacher, Former Employer and/or someone who has known you well for some time. Each form is to be returned directly to our office and your application can only be processed when we have both references in hand.

Supporting Documents
In support of your application, please submit photocopies of any document such as awards, certificates or official qualifications.

Personal Interview
Please indicate what the best date(s) and times(s) would be for you to come to Toronto for a mandatory personal interview.

Date:    Time:

Date:    Time: