Form

Junior Staff -- Iowa 4-H Center

Please fill out this application if you are interested in our Junior Staff Positions. Junior Staff must be 18 years of age and graduated from high school. Pay will be dependent on how many weeks are available for work. Junior Staff may volunteer in different areas of staff. Please contact Abbie at aeparker@iastate.edu if you have any questions
Full Name*
First Name Last Name
E-mail*
Phone Number
- Area Code Phone Number
What are you able to attend during staff training?

All of it! I can be there May 21-June 2 Only a few days, which can be determined in an interview None, I have conflicts and will not be able to attend any of staff training
I am able to get certified in one of these areas May 25-27, 2012

Lifeguarding Climbing Tower & High Ropes None, these dates conflict with other plans
I currently already have the following certifications:

First Aid CPR Lifeguard
I am able to work/volunteer the following weeks:*

Week 1: June 3-9 Week 2: June 10-16 Week 3: June 17-23 Week 4: June 24-30 Week 4 1/2: June 30-July 2 Week 5: July 8-14 Week 6: July 15-21 Week 7: July 22-28 Week 8: July 29-August 4 Week 9: August 5-10
What is your t-shirt size

Small Medium Large X-Large XX-Large
Please list 3 references (Name, Email address, phone number, relationship with you)*
What are your areas of interest? What would you like to do at camp?*
What do you see as elements to a successful camp program?*
Explains what it means to be a role model?*
I hereby attest to the accuracy of the information I have provided. I authorize camp to investigate the statements herein, including background checks, work history, and driving records, and release the Iowa 4-H Center and all others from any associated liability. I understand that any misrepresentation or omission may be grounds for discharge whenever discovered. I further acknowledge that any employment with the Iowa 4-H Center is contingent upon satisfactory clearance of my criminal history and driving record. I waive my right to review references or recommendation, understanding that their contents are confidential and will not be available to me now or in the future. I am familiar with the general characteristics of the Iowa 4-H Center, the program offered, and the campers attending*
Should be Empty:

Junior Staff -- Iowa 4-H Center