Purchase and Boat School Application

Name:
Street Address:
City
State:	Country:
Postal Zip
Phone:	( ) -
Alternate Number:	( ) -
E-mail Address:
Sex:	Female Male
Tell us what boat your interests you?	Chesapeake 17' or 17'Lt West River 18' Mill Creek 13' or 15' Annnapolis Pram Wherry Skerry
Do you what to buy it built by us or build it yourself?	Buy I want to build it in your school
We accept all Major Credit Cards

Please review the above application before clicking the Submit button. Submitting this form will serve as your acknowledgment that the above information is correct.

Staff Application

Position You Are Applying For:
Name:
Street Address:
City:
State:	Country:
Postal Zip:
Phone:	( ) -
Alternate Number:	( ) -
E-mail Address:
Sex:	Female Male
Birthdate:
Tell us what activities you are applying for?	Coordinator Activities Leader Group Leader Aquatics

Education

College:
High

Camp Experience - As Either a Camper or Staff Member
(Lack of experience is not an employment obstacle)

Camp:
Director:
Phone #:	( ) -
Dates:
Salary:
Other work experience related to working with people such as teams, organizing committees or clubs.

Activity Information

Please list 3 activities, in order of preference, that you feel most qualified to organize or teach at Camp Kiwi.

Red Cross Certificates Do you currently hold any Red Cross Waterfront Instructor Certificates? If so, please list expiration dates:

WSI:
First Aid:
LGT:
CPR/Type:

Other Important Information

 

Dates Available for Camp:		June - August , 2003
Age Preference:		3-5 year olds 6-7 year olds 8-13 year olds 14-15 C.I.T. Training
Tell us about a time when you made a difference in the life of a child or another human being?.
Kiwi would like to hear about the biggest and toughest challenge of your life and how you dealt with it?
Tell us about a time when you learned a valuable life experience. How has this experience benefited your life? Who is your role model and why?
Have you ever been involved in a emergency situation? Tell us how you handled the situation.
How did you hear about Kiwi?
Have you ever been convicted of a crime?		Yes No
Please list any restrictions including dietary and physical that would be pertinent to camp life.Please explain:		Yes No

Please review the above application before clicking the Submit button. Submitting this form will serve as your acknowledgment that the above information is correct.