4-H Cit Teen Leader Camp Application s1

2018 4-H RETURNING CAMP COUNSELOR APPLICATION / DUE 11/20/17

Position – ONLY check Teen Director / Assistant Director if you are eligible and interested in applying. MUST BE 15-18 with 2 YEARS EXPERIENCE AS PACK LEADER. Check all others that may apply.

Teen Director [ ] Assistant Teen Director ____

Pack Leader (15-18 years) _____

Assistant Pack Leader/ Cabin Leader / Activity Leader (14-18 years) _____

Name ______

Age as of JUNE 1, 2018 ______

Birth Date ______

Address _

Parents / Guardians Name ______

Parent/Guardian Cell Phone or Home Phone __ _

Your Cell Phone __ _

Your Email Address _ _

Parent/Guardian Email Address _ _

School____ Current Grade ______

Race Data: this information is requested on an optional basis. Your cooperation in providing it is appreciated. Please check the box that indicates your race which will be used only for reporting purposes.

Native American _____

Asian :_ ____

Hispanic _____

Black _____

White _____]

Other

Number of years attended 4-H Junior Camp as a Camper _____

Number of years attended 4-H Intermediate Camp as a Camper _____

List number of times you have served as each of the following, specifying Junior/Intermediate Camp:

# times as Cabin / Activity Leader: _JR INTERMEDIATE CLOVER ____

# times as Pack Teen Leader: JR INTERMEDIATE _____

# times Teen Director/Assistant Director: _JR INTERMEDIATE ____

List Other Camp Experiences and Your Role (Day Camp, Sports, Girl Scouts, Boy Scouts, Specialty)

List any Work Experience(s) and Your Role:

“A LEADER IS A TEAM PLAYER, A DOER, A HELPER, AN ENCOURAGER, AND A GOOD LISTENER.” Explain how you fit this definition and how it applies to your role as a Counselor.

What is your camping philosophy?

What do you feel is the role of ALL the adult volunteers at Camp, not just the Adult Camp Directors? How does your position as a Camp Counselor relate?

4-H and Extra-Curricular Activities: Include Leadership positions held with each activity listed i.e. Officer, Captain, Co-captain, Group or Committee Leader, Assistant positions held partnering with an adult.

1. School:

2. Community:

3. 4-H other than Camp (Club, County, State)

4. Service Learning (Community Service):

5. Hobbies/Hidden Talents:

Describe any experiences working with younger youth, other than Camp. Include what you like most when working with younger youth and with what age group you prefer to work.

What are some of the reasons for conducting 4-H Camp, besides “FUN”?

What will you gain from your experiences as a Camp Counselor that will help you in future endeavors?

Do you think you are a good role model? Why?

If you are chosen as a Counselor, list at least three goals you hope to accomplish at Camp this year.

What is your favorite part of 4-H Camp and why do you think it is important?

What way did you help the Campers have a memorable experience at Camp last year?

What do you feel YOU need to work on to become a better Counselor this year?

If you could recommend a subject to be addressed at counselor training to help you in the counselor role at camp, what would it be? Explain.

Camp is physically, emotionally, and mentally stressful. In recent years we have implemented early curfews. What other ways can we make the last two days of camp as “GREAT” as the first two for every one involved ?

If you are accepted, which activities would you like to assist with?

_____ Crafts _____ Riflery _____ Newspaper _____ Sports

_____ Archery _____ Drama _____ Hiking _____ Outdoor Cooking

_____ Nature Activities (specify) Robotics

**DIRECTOR AND ASSISTANT DIRECTOR APPLICANTS ONLY: Explain- What is the role of a Teen Director/Assistant Teen Director? What is your relationship to the Camp Adult Directors, other Counselors and Campers? Why should you be chosen for this position?

***NOTE: CHOSEN APPLICANTS WILL BE INTERVIEWED BY A PANEL AND MUST GIVE A PRESENTATION ON AN ASSIGNED TOPIC RELATED TO CAMP. NOT ALL APPLICANTS WILL BE CHOSEN. PREVIOUS PERFORMANCE WILL BE CONSIDERED.

REMINDER: BEING A HIGH SCHOOL SENIOR DOES NOT AUTOMATICALLY MAKE YOU A TEEN DIRECTOR, NOR DOES PREVIOUSLY SERVING AS AN ASSISTANT DIRECTOR.

Training and/or certificates you already have:

_____ Red Cross First Aid Certification _____ Red Cross Certified Life Guard

_____ Water Safety Instructor _____ CPR Certification

_____ Know basic sign language ____ Can Swim _____ Cannot Swim

___-__ Other (please list)

Please supply contact information for two non-family references. (We will be sending them a reference form to complete.)

Name / Title: ______Phone /Email/ Mailing Address __ _

Name / Title: ______Phone / Email/ Mailing Address __ ___

*** COST : Harford County 4-H Club Members $55 / Non-4-H Club Members $65 – Due 3/3/2018

***DEADLINE FOR APPLICATION: NOVEMBER 20, 2017

Check Camps you will be AVAILABLE to attend. (You may not be chosen for all camps you are available to attend.)

Intermediate Camp – June 24-June 29, 2018

Junior Camp – July 8-12, 2018

Clover Camp – Week of June 18th OR July 2nd (Final date not decided)

In completing and submitting this application, I understand that my selection to participate as a Camp Teen Staff Member is based upon ALL criteria stated in the Applicant Agreement.

______

Teen/ Applicant Signature Date

______

Parent / Guardian Signature Date

The University of Maryland, College of Agriculture and Natural Resources programs are open to all and will not discriminate against anyone because of race, age, sex, color, sexual orientation, physical or mental disability, religion, ancestry, or national origin, marital status, genetic information, or political affiliation, or gender identity and expression.

2018 APLICANT AGREEMENT FOR CAMP COUNSELOR

(Copy of Signed Agreement with Original Signatures Must be Submitted by 2/3/18)

In completing and submitting this application, I understand that if selected to serve as a Teen Counselor I will be expected to attend and participate in 32 hours of mandatory meetings and trainings completed by June 1, 2018

I also understand that my selection to participate as a camp teen staff member is based upon

the following criteria:

· Submission of Camp Counselor Application by November 20, 2017

· Completion of 4-H Enrollment for 2018

· Completion of 4-H Behavior Expectations for 2018

· Payment of Registration Fees by March 3, 2018 (Checks made payable to HCEAC)

· Checking of References

· Previous Camp and Leadership Experience

· Completion of 4 Hours of Camp Service by June 1, 2018

· Age, as stipulated under the ACA Camping Standards

· Adhering to Camp and 4-H Behavior Expectations

· Adhering to the University of Maryland, Maryland 4-H and Harford County 4-H policies and procedures.

* I also recognize the commitment and responsibility involved with being a 4-H Camp Counselor and I believe I am able to accept the challenge.

*I understand that the failure to meet DEADLINES will affect my eligibility to serve as a 4-H Camp Counselor in any role.

*I understand that my status as a Harford County 4-H Camp Counselor may be terminated at any time for failure to abide by these and other policies and procedures.

______

Teen/ Applicant Signature Date

My child has my permission to apply to be a 4-H Camp Counselor for Harford County. I realize the responsibility the position holds. I feel my child can accept the commitment and follow through with all assigned tasks and duties.

______

Signature of Parent/Guardian Date

affiliation, or gender identity and expression.