Camp Kirk Staff Application

Today's Date *

Your Name *

First

Last

Pronouns

Will you be 19 years old by June 2023?

Yes
No
I turn 19 in the summer

Email *

Phone Number *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

	No experience	Some experience	Lots of experience	Have taught/facilitated program
Swim	No experienceSwim No experience	Some experienceSwim Some experience	Lots of experienceSwim Lots of experience	Have taught/facilitated programSwim Have taught/facilitated program
Archery	No experienceArchery No experience	Some experienceArchery Some experience	Lots of experienceArchery Lots of experience	Have taught/facilitated programArchery Have taught/facilitated program
A&C	No experienceA&C No experience	Some experienceA&C Some experience	Lots of experienceA&C Lots of experience	Have taught/facilitated programA&C Have taught/facilitated program
Pottery	No experiencePottery No experience	Some experiencePottery Some experience	Lots of experiencePottery Lots of experience	Have taught/facilitated programPottery Have taught/facilitated program
Challenge Ropes Course	No experienceChallenge Ropes Course No experience	Some experienceChallenge Ropes Course Some experience	Lots of experienceChallenge Ropes Course Lots of experience	Have taught/facilitated programChallenge Ropes Course Have taught/facilitated program
Rock Climbing	No experienceRock Climbing No experience	Some experienceRock Climbing Some experience	Lots of experienceRock Climbing Lots of experience	Have taught/facilitated programRock Climbing Have taught/facilitated program
Leadership Programming	No experienceLeadership Programming No experience	Some experienceLeadership Programming Some experience	Lots of experienceLeadership Programming Lots of experience	Have taught/facilitated programLeadership Programming Have taught/facilitated program
Drama	No experienceDrama No experience	Some experienceDrama Some experience	Lots of experienceDrama Lots of experience	Have taught/facilitated programDrama Have taught/facilitated program
Music	No experienceMusic No experience	Some experienceMusic Some experience	Lots of experienceMusic Lots of experience	Have taught/facilitated programMusic Have taught/facilitated program
Martial Arts	No experienceMartial Arts No experience	Some experienceMartial Arts Some experience	Lots of experienceMartial Arts Lots of experience	Have taught/facilitated programMartial Arts Have taught/facilitated program
Ecology/ Nature Programming	No experienceEcology/ Nature Programming No experience	Some experienceEcology/ Nature Programming Some experience	Lots of experienceEcology/ Nature Programming Lots of experience	Have taught/facilitated programEcology/ Nature Programming Have taught/facilitated program
Camping + Outdoors Skills	No experienceCamping + Outdoors Skills No experience	Some experienceCamping + Outdoors Skills Some experience	Lots of experienceCamping + Outdoors Skills Lots of experience	Have taught/facilitated programCamping + Outdoors Skills Have taught/facilitated program
Canoeing	No experienceCanoeing No experience	Some experienceCanoeing Some experience	Lots of experienceCanoeing Lots of experience	Have taught/facilitated programCanoeing Have taught/facilitated program
Sports	No experienceSports No experience	Some experienceSports Some experience	Lots of experienceSports Lots of experience	Have taught/facilitated programSports Have taught/facilitated program

How did you learn about Camp Kirk? *

If a former staff referred you to Camp Kirk, please share their name:

Please list any personal or professional experience you have with the neurodivergent and/or disability community

Why do you want to work at Camp Kirk? *

Please upload a current copy of your resume *

Click or drag a file to this area to upload.

Certification