Madawaska Staff Application

Please take the time to fill out all necessary fields. Enter N/A where appropriate.

The first two sections of this form are MANDATORY.

SECTION 1
I am applying to:
Volleyball
All-Sport
Position(s) for which you are applying:
SECTION 2
Name:
Gender:
Permanent Address:
Street:
Apt:
City:
Province:
Postal Code:
Phone Number 1:
Phone Number 2:
Temporary Address:
(For example college)
I will be at this address from:
select
I will be at this address until:
select
Street:
Apt:
City:
Province:
Phone Number 1:
Phone Number 2:
Email Address:
Birthdate
Club Affiliation:
Please be prepared to provide Social Insurance & Health Card numbers at the interview.
SECTION 3
Educational Background:
High School
College
University
High School Name:
City
I was here from:
select
I was here until
select
College or University Name:
City:
Province/State:
Major Subjects:
Degree/Major:
SECTION 4
Camp Background:
Years as a camper:
Last 3 camps attended:
Did you attend a camp CIT/LIT training program?
If yes, which camp(s)?
Camp Staff Background:
(if this does not apply, skip to Section 5)
Camp:
Dates (years attended 19xx):
Positions:
Director:
Phone:
SECTION 5
Other Employment:
Employer 1:
Worked here from:
select
Worked here until:
select
Nature of work:
Phone:
Supervisor:
Reason for Leaving:
Employer 2:
Worked here from:
select
Worked here until:
select
Nature of work:
Phone:
Supervisor:
Reason for Leaving:
We require at least 3 references. The Camp Director(s) and employers listed above will be contacted and may be used as reference. If you are providing other references they should not be relatives and should have knowledge of your character, experience and ability.
Reference 1:
Name:
Phone:
Address:
City:
Prov:
What type of reference will the above provide (eg. Camp Director, employer, teacher, clergy etc.)
Reference 2:
Name:
Phone:
Address:
City:
Prov:
What type of reference will the above provide (eg. Camp Director, employer, teacher, clergy etc.)
Reference 3:
Name:
Phone:
Address:
City:
Prov:
What type of reference will the above provide (eg. Camp Director, employer, teacher, clergy etc.)
SECTION 6
Other Certifications:
NLS
Expiry:
select
First Aid
Issuing Agency:
Expiry:
select
CPR (Basic)
Issuing Agency:
Expiry:
select
Special Interests:
What contributions do you think you can make at camp?
What contributions do you think a well run camp can make to a child?
Write a brief note explaining what camp, school or other training and what experiences you have had that will allow you to be successful at the job for which you are applying:
Other comments:
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2010-07-27
Celebrate Canada Day at Madawaska Volleyball Camp!

Remember to pack some RED and WHITE clothing for the day we celebrate our "True North Strong and Free" during volleyball camp!


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