CSD Application

Name *

First

Last

Birthdate

Month (##) *

Day (##) *

Year (####) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Gender *

Male Female

Scouting Background

Current Unit Number: *

Years in Scouting *

Rank obtained as a Scout *

Past Unit Positions *

Council *

Current Unit Position *

Order of the Arrow *

No Ordeal Brotherhood Vigil

Camp Background

Years at Camp as a Scout *

What Merit Badges have you earned that are relevant to the summer camp program? *

List any specialized training you have recieved: *

Character and community

What Church, School and Community activities are you involved in? *

What are your hobbies? *

How has Scouting benefited your life? *

What awards and recognitions have you recieved? *

What areas of Scouting do you like best? *

Staff placement

What areas at Camp do you feel most qualified to instruct? Why? *

Is there anything else you would like to tell us? *

Why do you want to work Kia Kima Staff? *

References

Please include contact information for both your references. (Address, Phone Number, Email)

Which Camp would you like to work in? *

Camp Osage Camp Cherokee

Please review this application carefully to affirm that the information is correct, to the best of your knowledge. In signing this application, you attest that the information given is true. You also agree to forfeit the right to view your employment file concerning reference information, in order to protect all parties involved. Once again, please read this application carefully before signing.

Kia Kima CSD Application

Personal Info

Birthdate

Scouting Background

Camp Background

Character and community

Staff placement

References