Camp Kern Counselor Application - Part I
For Forest Hills high school students who wish to apply to be a Camp Kern Counselor for 2012. Application is due by FEBRUARY 17 (Parts I and II, Part II is on paper). Once you have completed this part of the application you must hit SUBMIT at the bottom of the screen or your application will not be sent.
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Last Name
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First Name
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Current Grade Level
12
11
Other
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T-Shirt Size
XXL
XL
L
M
S
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Age as of May 7, 2012:
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Street Address
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Zip Code
45230
45244
45255
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Phone Number (best way to reach you)
Email Address
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Birthdate (M/D/Yr)
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School
Anderson
Turpin
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Male
Female
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Parent's Name (First and last name of one parent)
Please respond to the following questions.
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1. Were you a Camp Kern counselor last year?
Yes
No
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2. Did you apply to be a Camp Kern counselor last year?
Yes
No
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3. Are you/ or have you been a Say No or Peer Counselor?
Yes
No
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4a. Have you had any experience as a camp counselor?
Yes
No
4b. If you have been a camp counselor, explain and give dates.
5. Do you have a current Life Saving Certificate (to qualify as a Life Guard)?
Yes
No
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6. Have you ever been suspended from high school?
Yes
No
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7. Have you ever been expelled from high school?
Yes
No
If you answered "Yes" to either question #6 or #7, please explain.
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8. Have you ever been disciplined for your behavior in an extracurricular activity?
Yes
No
If you answered "Yes" to question #8 please explain.
9. Select the sessions below for which you would like to apply. DO NOT SELECT A CHOICE FOR A SESSION THAT YOU CANNOT ATTEND. Choose the sessions according to your preference and availability. Check your activity calendar (e.g. sports, band, orchestra), AP exam schedule,and consult with your family before making these selections. You will be considered for any session you select. Unfortunately, due to the large number of applicants for some sessions, not all applicants are selected. Session 2 will need the most counselors this year. The elementary school sessions are as follows: (Dates below) Session 1 - Ayer and Summit; Session 2 - Mercer and Wilson; Session 3 - Maddux and Sherwood.
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My first choice is:
Session 1 (May 7-9)
Session 2 (May 9-11)
Session 3 (May 14-16)
My second choice is:
Session 1 (May 7-9)
Session 2 (May 9-11)
Session 3 (May 14-16)
My third choice is:
Session 1 (May 7-9)
Session 2 (May 9-11)
Session 3 (May 14-16)
At camp, counselors assist with lessons. Indicate your preference for each lesson topic by ranking the 4 units below. Use a 1 to indicate your first choice, 2 for second choice, etc.
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10. Put the numbers 1, 2, 3, and 4 next to the units below according to your preference.
Field and Forest
Fossil Study
Pioneer Study
Pond Study
11. List names of two teachers who will be completing recommendation forms and subjects for each. (Must come from a teacher who has taught you in the past 2 years.)
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Teacher's Name
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Subject
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Teacher's Name
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Subject
Click the Submit button below to complete Part I of the Camp Kern application. Part II must be completed on paper hard copy, and submitted to high school guidance counselor's office by FEBRUARY 17. Part II includes written responses to 2 essay questions, 2 teacher recommendations, the Camp Kern pledge, and parent and student signature. Extra paper copies of the application are available in the counselor's office. Your application will not be considered complete unless both Parts I and II are submitted.
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Indicates Response Required