Use this form to apply for a position with our company. Please enter all information requested.LinkedInThis field is for validation purposes and should be left unchanged.Contact InformationEmail* Name* First Last Cell Phone*Home PhoneWork PhoneAddress* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Personal InformationDate of Birth* Position Applying For*Summer Camp Director/Assistant DirectorSummer Camp CounselorSummer Camp Junior CounselorIn-School Field Trip InstructorAfter School InstructorBirthday Party / Special Event SpecialistWhy do you feel you would be a good fit for the position you are applying for?*Education InformationEducation Status*Graduate degreeGraduate studentUndergraduate degreeUndergraduate studentHigh school degreeHigh school studentMost recent college/high school attended/attending*Undergrad MajorYear you graduated or will graduate college/high school:*Graduate school attendedCredentialed Teacher?* Yes NoDo you have CPR Certification?* Yes NoFirst Aid Certificate?* Yes NoWork and Camp HistoryPlease give a brief description of your work experience relevant to the position you are applying. You may paste work history from your resume.Please list your experience working with children in a classroom or summer camp settingReferences/General InformationList 2 professional references, at least one of which is a recent supervisor in a position relevant to this position:NameRelationship to YouEmail AddressTelephone Number Who do you know who might be interested in learning more about Club SciKidz employment opportunities?*Have you applied for a position with our company before?* Yes NoHow did you hear about this employment opportunity?*If you were referred by someone, list them here:Have you ever been convicted of a felony or misdemeanor?* Yes NoHave you ever been involved in an incident involving sexual or physical abuse of a child?* Yes NoMiscellaneous InformationDo you have any thoughts/comments about your preferred location? Please go to our website for after school or summer camp location preferences.*Do you have any physical conditions or diseases that would affect your abilities to perform all camp and classroom duties?* Yes NoIf yes, please explain:What is your availability during the summer?*Certification and ReleaseTo the best of my knowledge and belief, the information given truly represents my background and experience. I understand that if I have knowingly or negligently misrepresented, falsified or omitted any information during the application process, I may be disqualified for employment consideration or dismissed from employment with Club SciKidz.* I agree to allow Club SciKidz to do a background check.CommentsQuestion or CommentsΔ
