YMCA Camp Campbell - Cabin Leader Application

Want more information about our program before you apply? Email cabinleader@ymcasv.org

High School Authorization Sheet

If you are missing a week of school to volunteer, you will need to fill out a 'High School Authorization Sheet' first.

Print this form, get it signed by your teachers and school admin staff, then upload the completed copy below.

Note: If you are not missing any classes to volunteer, you can skip this part of the process.
Upload your completed 'High School Authorization Sheet' here

Attach Files
Name Name First Last
Age
Date of Birth (You must be at least 15 years old at the time of volunteering.) Date of Birth (You must be at least 15 years old at the time of volunteering.) / MM / DD YYYY
Gender
Help us better understand our volunteer demographics. Please select which group you identify with:
Do you attend school (High School or College)?

Do you attend school (High School or College)? Yes No
If yes, please list the school you currently attend
If you are currently in school, what class year will you be in at the time of volunteering? (You must be at least a high school sophomore to apply.)
If you were recruited by a teacher or parent at an elementary school, please put that school's name here:

We are offering a recruiting incentive to elementary schools to gain more volunteer support during their week at camp. Please include the name of the individual AND school that recruited you so we can give them appropriate credit.
1st Preference

Please select weeks that you can commit to coming to camp.

It is recommended that you select a 2nd and 3rd choice of weeks in case your first choice week does not have any available positions. You do not need to select a specific week more than once.
2nd Preference

Please select weeks that you can commit to coming to camp.

It is recommended that you select a 2nd and 3rd choice of weeks in case your first choice week does not have any available positions. You do not need to select a specific week more than once.
3rd Preference

Please select weeks that you can commit to coming to camp.

It is recommended that you select a 2nd and 3rd choice of weeks in case your first choice week does not have any available positions. You do not need to select a specific week more than once.
Are you new to volunteering at YMCA Camp Campbell, or are you a returner to our program?

Are you new to volunteering at YMCA Camp Campbell, or are you a returner to our program? New Returner
If you are a returner, please specify when you worked or volunteered.

Explain if you worked a previous week of Outdoor Science School, Summer Camp, etc. If you don't know exact times or dates, try to be as specific as possible. (**Examples** Week 14 - 2009 / Dec. 8-11, 2009 / Fall, 2009)
Contact Information
Primary Phone Number Primary Phone Number - ### - ### ####
Primary phone: Type of phone
Alternative Phone Number Alternative Phone Number - ### - ### ####
Alternative phone: Type of phone
May we contact you by text message to your cell phone?

May we contact you by text message to your cell phone? Yes No
Email address

Confirm Email Address
Parent's email address (if under 18)

Your parents will receive an email stating that you have applied to volunteer with us. This is to inform them of the responsibilities and requirements of our program.
Street Address Street Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Relevant Experiences: Please write a minimum of 2 to 3 sentences for each of these questions.
Other than earning service learning credit, why do you want to come to YMCA Camp Campbell as a Cabin Leader for our Outdoor Science School?
Minimum of 15 words required. Currently Entered: 0 words.
Describe a time that you were a leader or displayed leadership. How will that help you to be a successful Cabin Leader?
Minimum of 15 words required. Currently Entered: 0 words.
What does it mean to be a good role model? How will you be one for your campers?
Minimum of 15 words required. Currently Entered: 0 words.
What do you hope to contribute to Camp Campbell?
Minimum of 15 words required. Currently Entered: 0 words.
What do you hope to gain from your participation at Camp Campbell?
Minimum of 15 words required. Currently Entered: 0 words.
Have you ever been convicted of a criminal offense? (You may omit minor traffic offenses, any convictions which have been sealed, expunged or statutorily eradicated, convictions more than two years old for marijuana-related offenses for personal use, and misdemeanors for which probation was completed and the case judicially dismissed.)

Have you ever been convicted of a criminal offense? (You may omit minor traffic offenses, any convictions which have been sealed, expunged or statutorily eradicated, convictions more than two years old for marijuana-related offenses for personal use, and misdemeanors for which probation was completed and the case judicially dismissed.) Yes No

No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the
offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position will be considered. If employed by the YMCA
of Silicon Valley, and over the age of 18, you will be fingerprinted and a criminal history background check will be conducted. Should you be arrested or convicted while in the employ of the YMCA of Silicon Valley a subsequent arrest notification will be forwarded to the YMCA by the Department of Justice.
Have you been arrested for any criminal violation for which you are currently out on bail, out on your own recognizance or otherwise on release pending bail?

Have you been arrested for any criminal violation for which you are currently out on bail, out on your own recognizance or otherwise on release pending bail? Yes No

No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the
offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position will be considered. If employed by the YMCA
of Silicon Valley, and over the age of 18, you will be fingerprinted and a criminal history background check will be conducted. Should you be arrested or convicted while in the employ of the YMCA of Silicon Valley a subsequent arrest notification will be forwarded to the YMCA by the Department of Justice.
Are you a registered sex offender?

Are you a registered sex offender? Yes No

No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the
offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position will be considered. If employed by the YMCA
of Silicon Valley, and over the age of 18, you will be fingerprinted and a criminal history background check will be conducted. Should you be arrested or convicted while in the employ of the YMCA of Silicon Valley a subsequent arrest notification will be forwarded to the YMCA by the Department of Justice.
If you answered "Yes" to any of the above three questions, please use the following space to explain.
Please check the box if you agree to the following statement.

Please check the box if you agree to the following statement. I certify that the statements made by me in this application are true, complete and correct to the best of my knowledge and belief, and are made in good faith. I understand that falsification, misrepresentation, or omission of facts called for by this application could result in immediate dismissal as a volunteer.
Name Name First Last

YMCA Camp Campbell - Cabin Leader Application

YMCA Camp Campbell - Cabin Leader Application

High School Authorization Sheet

Contact Information

Relevant Experiences: Please write a minimum of 2 to 3 sentences for each of these questions.