First Name:
Last Name:
 
Position Desired
Doctor Certified Nurse Assistant - CNA
Nurse RN/NP Health Assistant
Nurses LPN Nurse Assistant - Not Certified
Emergency Medical Technician Other (Describe)
 
If you checked "Other" please describe
 
Available Dates: (Camps are generally from the first of June to the end of August)
from to
Email Address:
Address:
City:
    St:     Zip:
Home Phone:
Day Phone:

Cell Phone:

OK to Text?
 
Drivers License No:
State:   Expiration Date (mm-dd-yy)
 
Emergency Contact
First Name:
Last Name:
Address:
City:
    St:     Zip:
Home Phone:
Cell Phone:
 
Eligibility Information
Birthdate: (mm-dd-yy)
If hired, can you provide proof of eligibility to work in the U.S.?   Yes   No
 
Educational History
High School
(name and location)   Graduation Year
College / University
(name and location)   Level Completed:
Medical School / College
(name and location)   Level Completed:
 
Camping Experience (Not Required for Employment)
Name and Location of Other Camp(s) You’ve Attended/Staffed / Describe your experiences.
If you were sent to a camp for Whiz Resources do you want to return to the same camp this year?   Yes   No
Describe Camp Experience
Please Check Which Applies:
I would prefer to work at a special needs camp.
I only want to work at a special needs camp.
I would prefer to work at a traditional camp.
I only want to work at a traditional camp.
I am open to working at either a special needs or traditional camp.
 
Credentials and Certificates (Required only for Certain Positions)
Medical License / Certificate
MD    NP    RN    LPN    EMT    CNA    Other
License Number:
State:   Date Received (mm-dd-yy)   Expiration Date (mm-dd-yy)
 
Other Training, Licenses, Certifications with Related Information (Describe)
 
Occupational History and Skills
List your three most recent employment and/or volunteer experiences.
Business Name:
Contact Name:
Address:
Phone Number:
 
Dates Employed:
 
Business Name:
Contact Name:
Address:
Phone Number:
 
Dates Employed:
 
Business Name:
Contact Name:
Address:
Phone Number:
 
Dates Employed:
 
Describe any skills or talents you bring that will help you at the camp.
Briefly state the main reasons you would like to work at a camp.
The best time to reach me for a telephone interview is (include Time Zone) and the best phone number to call is (include Area Code).
A thorough background check will be performed on all applicants. Other than minor traffic violations, is there anything on your record that might appear on a background check?
Yes   No
If yes, please provide details below:
 
I certify that the information I have provided above is true and complete and understand that, if hired, any misrepresentation could result in removal from my job. By submitting this application I also agree to allow WhizResources and camps considering my employment to run all background checks they deem necessary. WhizResources will process my application and, at its discretion, may forward it to a camp for consideration for a summer camp staff position. If I am hired, the contract for my services will be directly between me and the camp that employs me. I agree to hold harmless WhizResources for any and all claims arising from employment related directly or indirectly to the actions of WhizResources and this Application. I understand that WhizResources is an independently owned entity, providing services for camps and that WhizResources is not owned or operated by or otherwise related to any camps or other non-profit or for-profit organizations owning or managing the camps. The camps have agreed to pay WhizResources for its services and I will not be required to make payment to WhizResources unless I terminate early my contract with the camp, in which case I will reimburse WhizResources for any and all expenses related to transportation provided or reserved on my behalf and paid by WhizResources.
By submitting this application I agree to the above statement.
Date: (mm-dd-yy)