Camp HOPE, Inc. · Volunteer Staff Application

Contact Information

Name

First Name

Last Name

Email

*

Verify Email

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

County

Phone Number

What number can we best reach you by?

Emergency/Health Information

Emergency Contact Name

Person we can reach in case of an emergency.

Emergency Contact Phone Number

Phone number of person we can reach in case of an emergency.

Do you have any health conditions or allergies?

If yes, please list:

Do you have a special diet or meal preference?

My gender or gender identity is best described as:

If you selected "another gender not listed" for your gender or gender identity, please describe:

My race or ethnicity identity is best described as:

Select all that apply

American Indian or Alaska Native

Asian

Black or African American

White

Hispanic or Latina/o/x

Native Hawaiian or Other Pacific Islander

Middle Eastern or North African

Another race/ethnicity not listed

If you selected "another race/ethnicity not listed" for your race/ethnicity, please describe:

What is your date of birth?

(mm/dd/yyyy)

Education

School Names, Locations, Majors

Did you graduate?

Professional Certifications, Societies, Associations, Awards or Publications?

Work Experience

Present or Most Recent Employer:

Company Name, Job Title, Company Address, Date Started, Date Left, Supervisor's Name and Telephone Number, Description of Job Duties/Responsibilities

Previous Employer Information:

List any relevant work experience, reason for leaving

Volunteer Experience

Please list any recent volunteer experience:

Include agency name, responsibilities, and how long you volunteered for.

Authorization to Check Criminal Records

AUTHORIZATION TO CHECK CRIMINAL RECORDS:

I authorize Camp HOPE to receive:

Information from any law-enforcement agency, including police departments and sheriff’s departments, of this state or any other state or federal government, to the extent permitted by state and federal law, pertaining to any convictions for crimes committed upon children.

I understand that such access is for the purpose of considering my application as a volunteer and that I expressly DO NOT authorize the camp, its directors, officers or other volunteers to disseminate this information in any way to any other individual, group, agency, organization or corporation.

Signature of Applicant

(Type full name including middle initial.)

Signature Date

(mm/dd/yyyy)

Do you have a valid driver's license?

Interest in Volunteering at Camp HOPE

Were you a previous camper?

No

Yes - Child Camper

Yes - Adult Camper

Have you experienced the death of a loved one?

This is not necessary for volunteering at Camp HOPE

Please explain how your loved one(s) died

Why do we ask this? We are strategic in how we place counselors and campers together. For example, if your loved one died from cancer and we have a group with multiple children who've also lost loved ones to cancer, that might make a beautiful fit.

INTEREST IN CAMP HOPE

INTEREST IN CAMP HOPE: Please explain your reasons for becoming interested in Camp HOPE, ie: your personal experience with death and grief, your work with children and teens, etc.