Counselor Application

Applicant's Last Name*

Last Name

Applicant's First and Middle Name(s)*

First Name Middle Name

Applicant's Nickname (prefers to be called)

Nickname

DOB*

Email*

Enter Email Confirm Email

Home Phone (if applicable)

Cell Phone*

Current school or employer*

Grade for 2023-24 (if appl.)

Mailing Address*

Street Address or PO Box City State / Province / Region ZIP / Postal Code Country

How did you find out about Camp Greenbrier?*

T-Shirt Size*

Do you have a driver's license?*

Yes
No
No, but I will by the time camp starts

Do you smoke?*

Yes
No

Do you vape?*

Yes
No

Can you swim?*

Yes
No

Dates of Employment*

The dates of employment range from Friday, June 14, 2024 to Friday, August 23, 2024. Are you able to be at Camp for this entire period? (Note that Counselor Orientation runs from June 14 to June 22; Boys Camp runs from June 23 to August 4 for staff; House Party runs from August 3 to August 18 for staff; and Take Down runs from August 18 to August 23 (at the latest, weather dependent)).

Yes
No

If you answered “No,” please list the dates when you are available.

Reason for Requesting Employment:*

Please describe why you would like to be a counselor at Camp Greenbrier

Employment History:

List all jobs you have held over the last 10 years (including all volunteer positions, especially where you worked with children). Describe your job duties for each. State your reason for leaving each job. List the name of each employer and a current phone number for each employer. Click on the + to add additional jobs.

Employer Name	Job Description	Reason for Leaving	Supervisor Name	Supervisor's Phone Number / Email

Activities in Which You Have Knowledge*

Please select each activity in which you feel knowledgeable.

Activities You Can Teach*

Please select each activity in which you feel qualified to instruct campers.

Activities Preferences*

Please select UP TO THREE activities you would like to teach, in order of preference.

Additional Comments

Please include any comments on your activity choices here (how strongly you would like to teach one activity versus another; where you have the most expertise; etc).

Additional Information

List any other information that you believe is pertinent to this application, including your experience/skills taking care of or teaching children and any current certifications (CPR, lifeguard, first aid, etc.). Feel free to include your resume/CV if you have one.

Job Requirements: Being a camp counselor is fun and rewarding, but at times can be hard work. Some of the responsibilities a counselor has include:

• Long hours during which you are on duty, with limited breaks

• Managing difficult camper behavior

• Being asked to handle duties not normally asked of you, sometimes at the last minute

• Teaching an activity and/or supervising campers during inclement weather (rain, heat, etc.)

• Being required to go long periods without access to electronics (mobile phones, etc.)

• Maintaining a positive, kind attitude even during difficult circumstances

Do you believe that you have the appropriate temperament, discipline, and attitude to be a camp counselor?*

Yes
No

Below, please list any concerns you have about being a camp counselor, including anything which might hinder your ability to be an effective counselor.

Authorization to Check Criminal Records: I, the undersigned, authorize Camp Greenbrier and/or its agents, to receive information from any law enforcement agency, including police departments and sheriff’s departments, of the state of West Virginia, or any other state or federal government, to the extent permitted by state and federal law, pertaining to any convictions I may have had for violations of state or federal criminal laws. I understand that such access is for the purpose of considering my application as an employee and that I expressly do not authorize the Camp, its directors, officers, employees, or other volunteers to disseminate this information in any way to any other individual, group, agency, organization, or corporation.

Signature*

Date*

Have you ever been convicted of, or arrested for, a violation of the law (including but not limited to traffic violations)?*

Yes
No

Explain

Are you currently subject to any court order involving an alleged violation of the law (including but not limited to a summons or court order to appear before any court)?*

Yes
No

Explain

Certification: By signing this application, I am certifying the following:

1. That I have not been convicted of any crime against children.

2. That I have not been convicted of, or arrested for, a violation of any law except as described above.

3. That I am not currently subject to any court order involving an alleged violation of the law.

4. That all of the information contained in this Application is true and complete.

5. That I will immediately report, in writing, any change in the information contained on this Application to the Camp Director.

Signature*

Date*

References*

Please list two character references below. References should be teachers, coaches, employers, etc. They should not be family friends or peers. Click on the + to add additional references.

Reference Name	Email	Phone Number	Relation to You	Years Known You

Recent Photograph*

Please include a recent photograph of yourself.

Max. file size: 512 MB.

I Would Like to Recommend a Potential Counselor:

Yes, I would like to recommend a friend to be a Camp Greenbrier counselor

Friend's Name

Friend's Email

Friend's Cell Phone

Friend's Age

How Do You Know Him

Counselor Application 2024

Winter Address:Sept. - May

Summer Address:June - August