Camp Kennybrook Staff Application

Camp Kennybrook Staff Photo

Please complete the staff application form below using the "Tab" key or your mouse to move through the fields.

NOTE: In accordance with the Children's Online Privacy Protection Act, a person must be 18 years of age or older to complete and submit this form.

Applicant Info  
First Name
Last Name
Sex Male Female
 
E-mail Address*
 
Present Mailing Address
(Date Effective Until)
Street/Apt/PO Box
City
State
Zip
Phone

Permanent Address/Info
(if different from above)		  
Street/Apt/PO Box
City
State
Zip
Phone
 
Height
Weight
Social Security #
Citizen of the USA Yes No
Date of Birth (mm/dd/yy)
High School Attended/
Year Graduated
College Attending/
Year Graduated
 
What is your educational background?
 
Previous Camp Experience
Camp:
Years:
Staff or Camper?

Camp:
Years:
Staff or Camper?
What are your main considerations in selecting a camp?
 
Previous work experience with children:
 
Do you hold a current American Red Cross Certificate? Yes No
If so, which one(s)?
 
Do you plan to have an automobile at camp? Yes No
 
Do you smoke? (*Required)
We are a non-smoking facility.		 Yes No
 
Any dietary restrictions? Yes No
 
Activities /Qualifications

If you are well-qualified and able to teach an activity, choose #1.
If you are interested in, but have little experience in an activity, choose #2.
If you have no experience with an activity, choose N/A.

Athletics
Aerobics
Archery
Baseball
Basketball
Gymnastics
Hockey
Lacrosse
Rollerblading
Soccer
Softball
Tennis
Volleyball
Weightlifting
Yoga


Water Sports
 Canoeing
Kayaking
Ski Boat Driver
Skiing
Swimming

Outdoor Life
Back Packing
Climbing Wall
Fishing
Horseback Riding
Mountain Biking
Pioneering
Ropes Course
Overnight Camping


Creative Arts
Ceramics
Cooking
Digital Camera
Jewelry
Leather Craft
Painting
Photography
Rocketry
Video
Woodmaking

Performing Arts
 Dance
Dramatics
Guitar
Other Instruments
 
Indicate your 1st and 2nd choice of age group for
cabin duty
1st: 6-9 10-12 13-15
2nd: 6-9 10-12 13-15

 

Have you ever played sports on a high school or college team?

 

What do you hope to get out of a summer as a camp counselor?

NOTE: Laundry, room and board are included.

 

References
Name, address and phone number of (2) ACADEMIC sources.
Please indicate whether the phone number is at school or home.

Reference 1

Reference 2

Please indicate a date, time, and phone number where you can be reached for an interview by one of our directors:
Date
Time
Phone #

Submitting this application certifies that the applicant has never been convicted of child abuse and authorizes Camp Kennybrook to conduct a criminal background investigation.

  

Winter Address
633 Saw Mill River Road
Ardsley, New York 10502
(914) 693-3037 | Fax: (914) 693-7678 (until June 20th)
E-mail: kennybrook@aol.com

Summer Office
PO Box 5014
73 Camp Road
Monticello, New York 12701
(845) 794-5320 | Fax: (845) 791-4738 (after June 20th)
E-mail: kennybrook@aol.com