CBS - 2017 Seasonal Staff - Teacher Application

Camp Burt R Shurly

2017 Online Seasonal Staff - Teacher Application

NOTE - APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS.

To begin the online application proces, click the Next button below. This application must be completed and submitted - it cannot be saved to be finished at a later time.

If you need more information on Seasonal Staff 2017, email don@campburtshurl.org, call us at 734.604.2959, or click HERE for more information on our website.
Gender *

Male Female
General information
Are you authorized to work in the U.S. on an unrestricted basis?? *

Yes No

Birth Date *
Applicant Name *

First Name Last Name
Social Security Number *
Driver's License Number *
Are you over 18 years old? *

Yes No
Home Phone *
Cell Phone
Work Phone

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail *
Facebook Page *
Twitter Name *
How did you learn of this opening? *

Employment History in the Education Field
Principal / Supervisor #1 (list the most recent employer first):

Principal / Supervisor #1 Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Principal / Supervisor #1 Phone:
Principal / Supervisor #1 E-mail:
Beginning and Ending Date for this Position:
Principal / Supervisor #2 (list the 2nd most recent employer first):

Principal / Supervisor #2 Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Principal / Supervisor #2 Phone:
Principal / Supervisor #2 E-mail:
Beginning and Ending Date for this Position:
Principal / Supervisor #3 (list the 3rd most recent employer first):

Principal / Supervisor #3 Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Principal / Supervisor #3 Phone:
Principal / Supervisor #3 E-mail:
Beginning and Ending Date for this Position:
In addition to your work history, what other experiences, skills or qualifications would especially fit you for work with our organization? Indicate additional experience, other than previously listed. Include any voluntary work.
Voluntary Work Experience
Voluntary Organization

Voluntary Organization Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Describe your voluntary work.
References
Reference #1
Full Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail *
Phone Number *

- Area Code Phone Number
Reference #2
Full Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail *
Phone Number *

- Area Code Phone Number
Reference #3
Full Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail *
Phone Number *

- Area Code Phone Number
OTHER SKILLS
Check any skills in which you are proficient.

Typing Personal Computer Microsoft WORD Microsoft EXCEL
List other skills
MILITARY HISTORY
Have you ever been in the Armed Forces? *

Yes No
Are you a member of the National Guard? *

Yes No

Questions & Acknowledgements
Why do you want to work at Camp Burt Shurly? *
What is your current teaching certification and other special endorsements? *
What are your prior experiences related to outdoor education? *
How could/should the outdoor space be utilized for academic instruction at DPS Camp Burt Shurly? *
Why do you want to teach for 1 week at DPS Camp Burt Shurly? *
Are you planning to bring your family with you during your week of camp (Please note: anyone over age 18, must have security clearance)? *
Would you be willing to assist in recruiting students from your own school to attend the week of camp that you are teaching at DPS Camp Burt Shurly? *
What do you consider to be your strongest personal assets that would come in handy working with children? *
What reservations, if any, do you have about working at Camp Burt Shurly? (Leave blank if none)
To All Applicants

The information requested below is needed to comply with state and federal laws and regulations. The information will be used for statistical purposes only and will not be used as part of the hiring process. Submission of this information is strictly voluntary and refusal to provide it will not subject you to any adverse treatment.
Ethnicity

American Indian or Alaskan Native Arabic Asian or Pacific Asian Black/African American Hispanic White/Caucasian Other
This Employer is an equal employment opportunity employer. We adhere to a policy of making employment deci- sions without regard to race, color, religion, sex, sexual orientation, national origin, citizen ship, age or disability. Opportunity for employment with this Employer depends solely on your qualifications. We reserve the right to select employees based upon religious preferences.
APPLICANT’S CERTIFICATION AGREEMENT: I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations on the application or otherwise made during the employment process will prevent a job offer or, if an offer is made, may result in my termination. I understand that this application and the personnel policies do not constitute employment. I understand that to be employed, I must be lawfully authorized to work in the United States and I must show the employer documents that will verify this. I, the undersigned applicant for employment, hereby authorize Detroit Rescue Mission Ministries, its agents, employees and representatives to obtain information concerning my employment, medical history, educational record, law enforcement record, and any other background information about me. I understand that any offer received is subject to my successfully completing all facets of the employer’s pre-employment screening process. I hereby understand that Detroit Rescue Mission Ministries has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment and hereby authorize Detroit Rescue Mission Ministries to perform medical examinations and/or drug screening. During the post-offer process, I authorize Detroit Rescue Mission Ministries to check employment references. I further understand that my employment with Detroit Rescue Mission Ministries shall be probationary for ninety (90) days, and further that at any time during the probationary period or thereafter, my employment relation with Detroit Rescue Mission Ministries is terminable at will for any reason by either party. I have read the application, completed it accurately and provide authorization for the above referenced information to be obtained by Detroit Rescue Mission Ministries. *

I agree
Should be Empty:

OTHER SKILLS

MILITARY HISTORY