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2021 Boxford Park Program - Staff Application
This information must be completed by applicant. If this form is completed by someone other that the applicant, the applicant may be in jeopardy of not getting hired. (we can tell)
Please complete all information below. Your answers are expected to be detailed, and a quality that reflects your effort and dedication. Please take your time to answer these questions.
Name
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First
Last
Street Address:
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Town, State and Zip code:
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Cell Phone:
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Email Address:
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Confirm Email Address:
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Date of Birth:
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Education-Grade entering in Fall 2021:
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Parent Name:
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Parent Phone:
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Parent Email Address:
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Confirm Parent Email Address:
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Reference #1 Name:
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Reference #1 contact number:
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How do you know reference #1?
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Reference #2 Name:
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Reference #2 contact number:
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How do you know reference #2?
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Have you worked for the Boxford Park Program before?
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Yes
No
If yes, how many years?
Please select
1
2
3
4 or more
Did you attend the Boxford Park Program as a camper?
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Please select
Yes
No
Please select the following:
(If so, provide copy)
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I am CPR/ First Aid certified.
I have a First Responder certification.
I do not have CPR/First Aid or First Responder Certification
What position are you applying for?
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Please select
Counselor (entering into grade 10 or higher in the Fall)(Paid position)
Intern (entering into grade 8 or 9 in the Fall)(Unpaid position)
CIT (Counselor in Training) (Entering into grade 7 in the Fall)(Discounted tuition rate)
Check the activities that you would enjoy doing with the children:
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Sports Games (soccer, kickball, whiffleball, teni-ball, etc.)
Field Games (tag, relay races, parachute, corn hole, capture the flag, water games, hula hoops)
Arts and Crafts-assist with making crafts, painting, etc.
Gimp, hemp, fusebeads-Teach/Supervise
Sidewalk activities-chalk, hopscotch, bubbles
Basketball
Oversee/play with kids in Playground
Four Square
Board Games, Cards, Giant Connect Four, Giant UNO, Giant Checkers, Giant Chutes n Ladders)
Music Games, Dance Contest
Do you have any specific ideas of games, activities and/or crafts (not mentioned above) that you would like to do with the children?
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Do you have any special skills and interests that you would like to teach the children? (basketball, soccer, golf, tennis, drawing, singing, dancing, cheering, etc.)
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Which age group do you prefer to work with?
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Please select
Kindergarten - Grade 2
Grade 3 - 4
Grade 5 - 6
Any grade
Explain why you would like to work with that age group. If you would like to work with any age group, explain why as well.
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What experience do you have working with children? Be specific.
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Are you available to work all 6 weeks of Park Program? (June 22-July 29) It is mandatory to work at least 4 of the 6 weeks.
List any schedule conflicts you may have.
(The Boxford Park Program runs on Tuesdays, Wednesdays, and Thursdays from 9:30am-12:30pm)
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DISCUSS one example of when you acted as a positive role model for a child/children.
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DISCUSS one example of when you acted as a positive role model among your peers.
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List 3 personal strengths:
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List 3 personal weaknesses:
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Do you have any allergies or medical conditions?
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No
Yes
If yes, please explain:
Acknowledgment/Disclosure Statements:
Have you received an in-school or out of school suspension in the last two years?
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No
Yes
If yes, please explain:
Have you been convicted of any crime or misdemeanor?
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No
Yes
If yes, please explain:
What is your T-shirt size? (for staff uniform ordering purposes, if you are hired)
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Please select
Adult Small
Adult Medium
Adult Large
Adult X-Large
By typing in your first and last name, you certify that the above information is accurate and correct. Please be advised that applicants 18 years or older will have to complete a CORI check (criminal background check). A copy of driver's license needs to be provided.
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Today's Date:
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Name
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Last
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