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*denotes required field
Name *
Social Security Number
Date of Birth
Height * " * Weight * Staff Shirt Size *
Permanent address (street and number)
City
State
Zip
Phone *
Cell Phone
School/Business address
City
State
Zip
Phone
Last date you can be reached at this address
Fax#
E-mail address *
Have you ever been convicted of a misdemeanor or felony? *
Yes No
Have you ever been convicted of child abuse or a sexual offense? *
Yes No
Are there any special physical or sensory facility needs that we should know to assure meaningful participation?
If yes, please describe below.
Education
High School/College
Major
Dates attended
Degree
College / Graduate School
Major subjects
Dates attended
Degree
List involvement with community service, clubs and associations
Camp Experience (camper or staff)
1) Camp
Address
Phone:
E-mail:
Your Position
Dates attended
2) Camp
Address
Phone:
E-mail:
Your Position
Dates attended
3) Camp
Address
Phone:
E-mail:
Your Position
Dates attended
Non-Camp Employment
1)Employer
Address
Phone:
E-mail:
Your Position
Dates employed
2)Employer
Address
Phone:
E-mail:
Your Position
Dates employed
3)Employer
Address
Phone:
E-mail:
Your Position
Dates employed
What type of position do you want at Lochearn?
Please give the earliest and latest dates you would be available:
From: To:
List current certifications. (Example: CHA, First Aid, CPR, Advanced Life Saving, WSI.)

In the following list select a 1 for those activities you are highly qualified to effectively teach. Select a 2 for those activities you have some knowledge and can serve as a teacher's assistant. Since Lochearn is a teaching camp, please only select those activities for which you have adequate knowledge, training and experience to teach.
Aerobics
Archery
Arts/Crafts
Basketball
Basketry
Bracelet Making
Camp Craft
Canoeing
Ceramics
Chorus
Creative Writing
Cross Country
Diving
Dramatics
English Horseback Riding
Evening Programs
Field Hockey
Fitness Training
Fimo Crafts
Guitar
Gymnastics
Hiking / Mtn. Climbing
Hip Hop Dance
Knitting/Crocheting
Lacrosse
Jazz Dance
Leadership Training
Musical Theatre
Nature Study
Piano Accompaniment
Quilting
Painting and Drawing
Pilates
Power Walking
Sailing
Sewing
Snorkeling
Soccer
Softball
Stage Craft
Swimming
Tennis
Volleyball
Wakeboarding
Waterskiing
Yoga

Please list any additional activities for which you have a keen interest and a high level of skill
From the activities listed above, which three activities, in order of your teaching ability, are you most interested in supervising or teaching at Lochearn? What background and qualifications do you have in each activity?
With what age group do you prefer to work most closely? (7/8/9/10/11/12/13/14/15) Please explain why:
How did you hear about Lochearn?






What is it about Lochearn that most appeals to you?
What main contribution do you think you can make at Lochearn?
References
-3 or more (teachers, employers, coaches, guidance counselors, supervisors, etc.) Refrain from listing friends or relatives.
Important -This section must have complete and accurate addresses, phone numbers and e-mail addresses.
1) Name
Relationship to you
Complete Address
Area Code/Telephone
Email
2) Name
Relationship to you
Complete Address
Area Code/Telephone
Email
3) Name
Relationship to you
Complete Address
Area Code/Telephone
Email
1. Describe your personal philosophy of working and caring for children. Include your views on discipline.
 
2. Select an activity you are qualified to teach an d outline a 50-minute plan. (What outcomes do you want for your students? How would you plan for these?)
3. Set forth a situation that is likely to occur in a cabin of six campers and describe how you, as the counselor, would respond to it.
4. Write a brief biography describing your family, background, responsibilities at home and elsewhere, interests, aims, and any experiences and qualifications not mentioned previously that are relevant to the position you seek.
Working at Lochearn demands of you an unselfish attitude. Your concerns and efforts must always be primarily directed toward the physical and psychological welfare of the campers. Though the management of Lochearn is very supportive, it is important that you recognize that camp counseling is a responsible job requiring a high level of care.
By typing my name below, I confirm that the statements in this application are correct and complete. I understand that any misrepresentation or omission of information shall be considered sufficient reason for withdrawal of an offer or subsequent termination of employment. I give Lochearn Camp permission to speak with any party who can ascertain my skills and character.
Full Name *
Date *
 

Lochearn Camp for Girls
Address: PO Box 44, 1061 Robinson Hill Road, Post Mills, VT 05058
Phone: 802 333-4211
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