KIA KIMA SCOUT RESERVATION
Scouts BSA Camp
Camp Osage
Camp Cherokee
Merit Badge Program
Ozark Venture Base
Provisional Camper
NYLT
Camperships
Cub Resident Camp
Winter Camp
Camp Staff
Summer Camp Staff
Camp Staff Development (CSD)
Resources
Leaders Guide
Directions & Maps
Forms
History
Contact Us
Trading Post
Chickasaw Council: (901) 327-4193
Personal Info
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Indicates required field
Name
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Email
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Phone Number
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Gender
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Male
Female
Birthday (MM/DD/YYYY)
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Scouting Background
Current Unit Number:
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Years in Scouting
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Rank obtained as a Scout
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Past Unit Positions
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Council
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Current Unit Position
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Order of the Arrow
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No
Ordeal
Brotherhood
Vigil
Camp Background
Years at Camp as a Scout
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Years at Camp as Staff
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Do not count CSD year
Past Staff Positions and Years
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Years at Camp as an Adult Leader
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Were you a CSD?
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Yes
No
List any specialized training/certifications:
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Character and community
What Church, School and Community activities are you involved in?
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What are your hobbies?
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How has Scouting benefited your life?
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What awards and recognitions have you recieved?
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What areas of Scouting do you like best?
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Staff placement
Your Top 3 Desired Positions at Camp
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What areas at Camp do you feel most qualified to instruct? Why?
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Why do you want to work Kia Kima Staff?
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What Merit Badges have you earned that are relevant to the summer camp program?
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Is there anything else you would like to tell us?
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References
Please include contact information for both your references. (Address, Phone Number, Email)
Reference #1
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Reference #2
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Dates Available this Summer:
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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.
Signature (Your name as you would sign it)
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Submit
Scouts BSA Camp
Camp Osage
Camp Cherokee
Merit Badge Program
Ozark Venture Base
Provisional Camper
NYLT
Camperships
Cub Resident Camp
Winter Camp
Camp Staff
Summer Camp Staff
Camp Staff Development (CSD)
Resources
Leaders Guide
Directions & Maps
Forms
History
Contact Us
Trading Post