Staff Application Form
Thank you for your interest in working at Decoma! Please submit your application by completing this form. You can also contact us with any questions at info@decomadaycamp.com
or give us a call at (847) 945-4455.
Name
Gender
Male
Female
Age (optional)
Address
Email
Phone
What position are you applying for?
GIRLS GROUP COUNSELOR
BOYS GROUP COUNSELOR
ACTIVITY STAFF
POOL STAFF
ARTS & CRAFTS DIRECTOR
Health Information
Can you perform the essential functions of the job with little or no accommodation?
Yes
No
If no, please describe.
Do you have any health restrictions or allergies that may impede your ability to perform the job applied for? If so, please describe.
Education Information
High School Name
Years Attended
Year in High School (If you have graduated please enter "graduated.”)
College Information (if applicable)
College Name
Current Address at College
Year in College (If you have graduated please enter "graduated.”)
Major
Degree
Present or Past Employment Information
Most Recent Position
Dates (from)
Dates (to)
Employer
Phone
Position
Supervisor
Reason for Leaving
2nd Most Recent Position
Dates (from)
Dates (to)
Employer
Phone
Supervisor
Reason for Leaving
References (list 2 non-relatives)
Name 1
Address 1
Phone 1
Name 2
Address 2
Phone 2
Camp Related Experience
Have you ever worked with children?
Yes
No
If Yes, describe the position. Include where and when.
Have you ever been a Decoma Day camper or staff member?
No
Yes, camper
Yes, staff member
Have you ever taught recreational activites?
Yes
No
If Yes, describe the position. Include where and when.
Experience (rank your experience level: 1=little or no experience, 2=familiar with, 3=excel at)
Archery
Arts & Crafts
Basketball
Cheerleading
Dance
Drama
Fencing
Fishing
Golf
Gymnastics
Horseback Riding
Lacrosse
Music/Singing
Soccer
Swimming
Tennis
Swimming/First Aid-CPR
Do you have a current certification in Life guarding and/or WSI through Red Cross, YMCA or Ellis?
Yes
No
Have you ever taught swimming?
Yes
No
Special achievements or activity in swimming (swim clubs or teams, WSI, intramural etc.)
Yes
No
If Yes, describe. Include where and when.
Are you currently certified in CPR?
Yes
No
Transportation Information
Do you have transportation to use on a daily basis?
Yes
No
Do you have a current ILLINOIS Driver’s License?
Yes
No
Are you 21 years or older?
Yes
No
Has your license ever been suspended or revoked?
Yes
No
Have you had any moving violations in the past two years?
Yes
No
Are you willing to meet a camp bus wherever we need you to?
Yes
No
Other Information
If you do not live in the Chicago area, do you have alternate housing available? (i.e. friend, relative)
Yes
No
Are you available to work the entire summer camp season June 8th - July 31 (Monday through Friday)?
Yes
No
When are you available for an interview?
Have you ever been convicted of any crime relating in any manner to children and/or your conduct with them?
Yes
No
Your Comments
Your Comments
Submit
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