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Summer 2012 Staff Application »

Home
Register Summer 2012
Youth Camps
Adult Camps
Retreat Center
Forms
Resources

Contact:
Phone: 530/626-3610
Fax: 530/626-8524
information@leonimeadows.org

Mailing Address:
PO Box 400
6100 Leoni Rd (for packages)
Grizzly Flats, CA 95636

. . .

Staff Application 2012

Because of Federal and State Laws, Leoni has made the minimum age requirement for working at camp 18 years old!

* Required

First *

Last *

Email Address *

Gender * Applies to gender specific jobs only

Male
Female

What is your age by June 17, 2012

Cell / Current Phone *

Home Phone *

Home Address *

Home City *

Home State *

Home Zip *

Current Address

Current City

Current State

Current Zip

Church you regularly attend *

Church where membership is held *

Background Information

Are you authorized to work in the US? *

Have you within the past twelve months abused any substance, taken any illegal drugs, or used tobacco and/or alcohol? * If Yes, please explain in the notes at the end of this form

Have you ever been convicted of a felony or misdemeanor, other than a minor traffic offense? * If Yes, please explain in the notes at the end of this form

Have you ever been convicted of any child abuse and/or sex-related offense? *

Name of person, not a family member, who has known you five or more years, who can and may be asked to verify this statement. *

Please provide the Address, Occupation and Phone Number of person listed above *

Education / Training

Name of last school attended (or presently attending) *

Address of School *

What was the last grade you completed? *

List diploma(s) and/or degree(s) received *

If you attended college what was (is) your major?

Describe any specialized training (music, language, apprenticeship, skill and extracurricular activities). *

Please list your special interests and hobbies. *

Provide any additional information you feel may be helpful to us in considering your application. *