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First For what position are you applying?*DriverDirector of FacilitiesMaintenance StaffPermanent Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Cell Phone*How did you learn about Keewaydin?* What date are you able to begin working?* MM slash DD slash YYYY Are you at least 18 years of age?* Yes No Are you 21 or older?* Yes No Do you have a valid driver's licence?* Yes No Do you have any restrictions on your licence?* Yes No Do you have experience driving a 15-passenger van?* Yes No Do you have experience driving a trailer?* Yes No Do you have a CDL* Yes No Do you have a passport or enhanced licence?* Yes No What is your driver's licence number and state?* Work, Camp, and Outdoor Experience and EducationWork History*Please list your past work history or volunteer jobs. Indicate dates of work, employer’s name, address and phone number, the nature of your work and reason for leaving. Explain any gaps in employment as well. To add another row press the plus sign to the right of the "reason for leaving" box. You may add as many boxes as you wish. DateCompanySupervisor Name, Address, and PhoneNature of your workReason for leaving Resume UploadIf you would also like to upload a resume in addition to filling out the work history above, please do so here. Max. file size: 50 MB.Have you attended or worked at any summer camps?*Yes, I have summer camp experience!No, I do not have camp experience.Camp Experience*Please list camps you have attended or worked at (with Director’s names as well) and indicate whether you were a camper or staff member. To add another row press the plus sign to the right of the "Camper/Staffmember" box. You may add as many boxes as you wish. Name of Camp and DirectorAddressPhone NumberDates of EmploymentCamper/Staffmember Do you have experience in the outdoors that is not summer camp related? Please tell us about it below.Education*High School and beyond. Indicate schools and training programs you have attended and indicate degrees or certificates which you have earned as well as any honors or awards. (Include CPR, First Aid, Wilderness First Aid, Lifeguard or other certifications.) To add another row press the plus sign to the right of the "Honors or Awards" box. You may add as many boxes as you wish. School/ProgramDatesEducation LevelDegrees/Certification AcheivedHonors or Awards ReferencesPlease provide contact information of THREE references and indicate in what capacity this person knows you. It is very important that you think carefully about whom you put down for references. It is best if there is a least one who has seen you working with kids. Other good references would be a teacher or professor who knows you well, or a supervisor in a job you have held. Another good reference is someone who has worked with you on a team, either in sports or in a work situation. While peers, friends and family members may know you well and can be good character references, they are not appropriate for referencesWe recommend you contact your references before you put them down and ask if they will serve as a reference for you. PLEASE NOTE THAT UPON HITTING "SUBMIT" ON THIS FORM AN EMAIL WILL AUTOMATICALLY BE SENT TO THE THREE REFERENCES YOU LIST BELOW. Reference 1: Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Reference 1: Relationship to you*This person is/was my:CoachTeacher/ProfSupervisorCoWorkerOtherReference 1: Other*You chose other, please explain this person's relationship to you. Reference 1: Email Address*What is the email address for the person that you listed as your first reference? Reference 1: Phone Number*Please list a good daytime phone number for the person you listed as your first reference.Reference 2: Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Reference 2: Relationship to you*This person is/was my:CoachTeacher/ProfSupervisorCoWorkerOtherReference 2: Other*You chose other, please explain this person's relationship to you. Reference 2: Email Address*What is the email address for the person that you listed as your second reference? Reference 2: Phone Number*Please list a good daytime phone number for the person you listed as your second reference.Reference 3: Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Reference 3: Relationship to you*This person is/was my:CoachTeacher/ProfSupervisorCoWorkerOtherReference 3: Other*You chose other, please explain this person's relationship to you. Reference 3: Email Address*What is the email address for the person that you listed as your third reference? Reference 3: Phone Number*Please list a good daytime phone number for the person you listed as your third reference. Harassment*We have an employment policy which prohibits all forms of harassment by our employees. This includes harassment on the basis of sex, race, religion or other protected classes of persons. Have you ever been accused of harassment of any person including, but not limited to, workplace harassment? No Yes If yes, please explain.*Criminal History*Have you ever been arrested and/or charged with a crime (other than minor traffic violations) including, without limitation, assault, sex-related and child abuse offences, and distribution and trafficking of narcotics or other controlled substances? No Yes If yes, please provide details.*Privacy Policy* I have read and agree to the Keewaydin Privacy PolicyBackground Check* I understand that if I am offered employment, Keewaydin intends to do a criminal reference check.Certification (Please read carefully before signing)I hereby affirm that the information provided on this application (and on any resume and other materials submitted) is true and complete. I understand that any false or misleading representations or omissions my disqualify me from further consideration for employment and may result in discharge if discovered at a later date. I understand that the completion of this application does not assure me of a position with Keewaydin (the “Camp”). I also understand that neither this application nor any other document constitutes a contract of employment for a specific term and that any employment relationship that may be established will be “at will.” I hereby authorize the Camp to investigate all information pertinent to my application in order to determine my qualifications for employment. I hereby authorize all persons and organizations having information relevant to my application to provide that information to the Camp and I hereby agree to hold the Camp and all those providing information to it harmless from any liability arising out of or as a result of the provision or use of such information. I understand that any offer of employment may be rescinded if my references are inadequate or unacceptable to the camp.Signature*By typing my name in the below box I agree that I am signing this application. Today's Date* MM slash DD slash YYYY
