Hamptons UMC - Camp Aide

CAMP AIDE

Applicant Information

First Name

Last Name

Phone Number

Date of birth

Address

Apartment, suite, etc.

City

State

Postal / Zip Code

Social Security No

Desired Salary:

Are you a citizen of the United States?

YES

Do you have a valid driver's license?

YES

Have you ever worked for this organization?

YES

If yes, Position & Dates worked

Have you ever been convicted of a felony?

YES

If yes, explain:

Education

High School:

Did you graduate?

YES

College:

Degree?

YES

References

Full Name

Relationship

Company

Phone

Previous Employment

Company Name

Company Address

Company Phone

Job Title

Starting and Ending Salary

Responsibilities

Reason for Leaving:

Date Stated

Date Ended

Company 2 Name

Company 2 Address

Company 2 Phone

Job Title 2

Starting and Ending Salary 2

Responsibilities 2

Reason for Leaving 2:

Date Started 2

Date Ended 2

May we contact your previous employer for a reference?

YES

Military Service

Have you served in the military?

YES

Branch

Date Entered

Date Left

Rank at Discharge:

Type of Discharge

Do you have any experience working with children?

YES

Please give a detailed description of responsibilities:

Signature

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