Position(s) applying for: ____________________ Paid ____ Volunteer ____ Date __________
Name: ___________________________________ SSN# _______________________________
Address: ______________________________ City: ___________State: ________ Zip: ________
Phone: _______________________ E-mail Address: _________________________________
Dates available to work: From ________to _______.
Do you have a valid driver's license? __ Yes __ No
Will you need reasonable accommodations (Americans with Disabilities Act) to perform the essential functions of the job(s) you are applying for? __Yes __No.
If so, explain what you will need in order to be able to do the job: ____________________________________________________________.
|Education Years||High School/College||College Major||Degree Granted|
Work Experience: Provide a full record of all employment for the last 10 years paid and volunteer and explain any gaps. Use separate sheet if needed.
|Start & End Dates||Employer & Supervisor||Address & Phone||Nature of Work||Reason for Leaving|
Personal References Give information for 3 persons (not relatives) who know your character, experience, work habits, abilities, etc.
|Name||Address & City||Phone|
What contribution do you think you can make at camp? (List skills, talents, expertise)
What contributions do you think that a well run camp can make to children?
I understand that I must sign a separate document (Disclosure & Authorization Form 2) that will authorize a criminal and/or other background check as a condition of my employment.
Mail with Disclosure & Authorization Form.
To: Three Links Youth Camp,
c/o Joy Maestretti, 112 Palin Ave. Galt, CA. 95632
If accepted, a physical examination may be required. All statements become part of any future personnel files and are treated confidentially.