Summer Job Application

Personal Information
First Name:
Middle Initial:
Last Name:
Age:
Sex:	Female Male
Permanent Address:
Permanent City:
Permanent State:
Permanent Zip:
Permanent Country:
College Address:
College City:
College State:
College Zip:
College Country:
Daytime Phone:
Nighttime phone:
Email:
Fax:
Job Information
First Job Choice:
Second Job Choice:
Can you work the whole summer?	Yes No
If not, please explain why:
Level of Education:
College Major:
What is your experience working with people with disabilities?
Work History
Employer #1
Business Name:
Contact Person:
Phone Number:
Employer #2
Business Name:
Contact Person:
Phone Number:
Employer #3
Business Name:
Contact Person:
Phone Number:
References Please list one of each:
Personal: (other than family)
Name:
Phone:
Work / School
Name:
Phone:
Why do you want to be a part of the Camp Joy team?
What gifts and talents would you bring to Camp Joy?
What dates and times are you available for an interview?	Date #1: Please select 3 times on this date you are available: Time #1: Time #2: Time #3: Date #2: Please select 3 times on this date you are available: Time #1: Time #2: Time #3: Date #1: Please select 3 times on this date you are available: Time #1: Time #2: Time #3:
Will distance from the camp warrant a telephone interview?	Yes No
Camp Joy is a smoke-free environment. Smoking is prohibited on Camp Joy grounds.