Camp Counselor Application

Lawrence County Camp Counselor Application

Print out this form, complete the application and return to the County Extension Office by February 20, 2004

NAME_______________________________________________________________________

ADDRESS____________________________________________________________________
(Road or Street) (City) (Zip)

PHONE(____)___________________________________CURRENT AGE________________

4-H Club______________________________________SCHOOL_______________________

PAST EXPERIENCE:

Have you been a 4-H camp counselor before? YES NO

Number of years as a counselor and\or CIT: __________

Other Camp Experience: (Describe)_____________________________________________

________________________________________________________________________

Please respond to the following:

Describe at least two main responsibilities of being a Camp Counselor.

___________________________________________________________________________

What are some personal qualities you feel a good camp counselor should possess.

___________________________________________________________________________

Suggest some camp themes and tribe names for this year's camp.

___________________________________________________________________________

In what areas do you feel there is a need for more counselor education? (ie. Safety, responsibilities, teaching, cabin management, programming? Others?)

___________________________________________________________________________

List your suggestions for camp programs, activities, events that you would like to see changed, improved, dropped or added?

___________________________________________________________________________

Every CIT and counselor are selected to serve on two committees listed below. Please select your top 4 choices. Rank according to your 1st, 2nd, 3rd and 4th choices.

_____Vespers _____Flags _____Daily D.J. _____Song Leader

_____Signature _____Slide Show_____Candle lighting _____Evening Program

_____Afternoon Program_____Closing Ceremonies _____Dress-up Dinner _____Camp Orientation

_____Special/Honor Camper _____Early Bird Activities

Explain why you selected your first 2 choices.

___________________________________________________________________________

Please read the commitment statement below carefully and sign in the space provide.

Camp Counselor commitment statement:

If chosen as a Camp Counselor, I will commit to understanding the requirements and responsibilities of being a good camp counselor. I will commit to regular meetings, camp fees, counselor training, camp dates and any other areas needed to perform my duties as a camp counselor. I further understand that if I do not meet the standards of a responsible counselor, I will be dismissed from my duties.

SIGNATURE__________________________________________________________________

Parent commitment statement:

As a parent (guardian) of he youth making this application, I understand the necessity to only select individuals that will be committed to the camping programming. I will, to the best of my ability, support and encourage this youth to uphold their commitment to the 4-H camping program if selected.

Parent/guardian signature__________________________________________________

Date_______________________

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Updated: December, 2003