Camp To Belong Wa Volunteers 2019

Volunteer/Counselor Application

CTB WA 2019 Summer Camp Dates:

Friday June 21st, 2019 - Saturday June 29th 2019

Please Note: Must be 21 years or older to apply (18-20 year olds may apply if enrolled in College in a career path working with youth ie: Social worker, Teacher, Counselor, RN, Pre-Med etc.).

ALL BACKGROUNDS CHECKS are performed through Verified Volunteers at a cost of $17. Upon completing this application please click on the button Verified Volunteers on our Volunteer Page to enter your social security number and other required information. Your background information is automatically sent to CTB WA Directors.

Are you a first time volunteer with Camp to Belong WA

Legal Name

AKA:

Phone Number

Address

Has this been your permanent residence for the the last 2 years?

Have you lived in Washington State for the last consecutive 7 years?

Date of Birth

Gender

Male
Female

I identify as

Male
Female

Drivers License or State ID

State Issued By:

Expiration Date:

Has your driver's license ever been suspended or revoked?

Have you ever been arrested for a crime?

Have you ever been convicted of a crime?

Additional Information:

Are you bilingual? (including American Sign Language)

T-Shirt Size

Employment History:

Current Employer:

Address

Phone Number

Supervisor Name:

Responsibilities:

Are you volunteering as a paid representative of your employer or agency?

Have you been employed by this company for the last 2 years?

Health & Safety Information:

Do you have food allergies

Do you have any dietary restrictions?

Date of last TB test:

How would you describe your health status?

Do you have any health issues that pose a risk to campers or staff?

Additonal Information:

Do you have current CPR training:

Do you have current First Aid Training:

Volunteer Experience

Camp To Belong WA is always in need of volunteers to assist in camp and year-round activities.

References:

List three persons, not relative, who have knowledge of your character, experience and ability to work with youth at the Camp To Belong WA Summer Camp. It is your responsibility to refer each individual to the Volunteer page and to fill out a reference letter for you.

ALL 3 Reference Letters must be submitted WITHIN 7 days of submitting your Volunteer Application

Reference #1

Name

Phone Number

Years Acquainted:

Relationship

Reference #2

Name

Phone Number

Years Acquainted:

Relationship:

Reference #3

Name

Phone Number

Years Acquainted:

Relationship:

Emergency Information

In the case of an emergency, please list those individuals we should contact.

Contact #1

Name

Address

Phone Number

Relationship to you:

Contact #2

Name

Address

Phone Number

Relationship to you:

Camp To Belong WA requires all full time volunteer staff to submit a background check through Verified Volunteers. After completing your volunteer application, please click on the Verified Volunteers Background Check button, it will take you directly to their website. The page you arrive at is specifically for Camp To Belong WA, and background check information will be delivered directly to Camp To Belong WA Directors. Verified Volunteers runs a state background check and checks all National Registry and databases. There is a one time charge of $17 that is paid directly to Verified Volunteers for their service.

Signature:

Please read the following and sign with finger or mouse:

I, the applicant, understand the opportunity to participate in the Camp To Belong WA Summer Camp is a volunteer position, and therefore money for services will not be exchanged. If I am traveling to a camp site outside of my home geographic area, I understand I am responsible for all transportation costs to and from CTBWA.
I also understand that I will be required to participate in Team Building Counselor training which may begin with reviewing documents that will come via e-mail prior to camp, as well as attend on site pre-camp training June 22rd - June 25th. Pre-camp Counselor Team Building & Training begins Friday, June 22rd @ 7pm, counselors and staff will not be departing camp until June 30th @ 1pm.
I authorize the investigation of all statements herein and release Camp To Belong WA and all others from liability in connection with it. I understand that if I am chosen to volunteer, it will be at-will, and any agreement to the contrary must be in writing and signed by Camp To Belong WA. I also understand that I am responsible for submitting a background check through Verified Volunteers.
I also understand that untrue, misleading or omitted information herein or in other documents completed by the applicant will result in dismissal regardless of the time of discovery by Camp To Belong WA.

I, the undersigned, agree to the terms above.

This page is secured with 256 bit encryption

Tell us about you:

Employment History:

Health & Safety Information:

Volunteer Experience

References:

Emergency Information

Signature:

Countdown:

NaN days, NaN hours, NaN minutes, NaN seconds