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Application for Camp Ranger

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Golden Spread Council, BSA

401 Tascosa Rd.

Amarillo, Texas 79124

www.goldenspread.org

Office: 806-358-6500

Fax: 806-358-7470

Application for

Camp Ranger

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Personal Information

Name__________________________Email_________________________________________ Home Phone (____) ____-______ Work (_____) _____-_______Cell (_____) _____-________ Present Address:________________________________City__________________State______ Are you over 25 years old?  Yes No 

Have you ever been convicted of a felony?  Yes No 

(You may answer “no” if your conviction has been ordered sealed, expunged or eradicated) Conviction is not an automatic bar to employment. All of the relevant circumstances surrounding the conviction will be considered in relation to the specific job requirements, including how long ago the conviction occurred and the nature of the crime involved. Provide complete information about the conviction by attaching a separate sheet.

Are you permitted to become legally employed in this country?  Yes No  (Proof of citizenship or immigration status will be required upon employment).

 Do you use illegal drugs?  Yes No 

 Have you ever been charged with child neglect or abuse?  Yes No   Has your driver’s license ever been suspended or revoked?  Yes No 

 Other than the above, is there any fact or circumstance involving you or your background that would call into question your being entrusted with the supervision, guidance, or care of young people and/or

property/equipment?  Yes No  (If yes, explain below.)

Education

Name and Location Graduated (Yes/No) Major

High School:______________________ _________ __________________ College:__________________________ _________ __________________ Tech-Voc. School: _________________ _________ __________________

Scouting

Are you now registered in Scouting? Yes  No  What position (s)?_________________ What Council/Unit are you registered in? (if applicable)_______________________________

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Adult training courses completed (include Wood Badge, National Camping School, etc) ____________________________________________________________________________ First Aid/CPR certification:_________________________Expiration date:________________

Licenses and Certifications

License or Certificate:____________________________License # (if applicable)___________

Issued by:______________________________________State/County:___________________ Issue Date:___________________Expiration Date:___________________________________

(Attach information about other licenses or certifications on a separate sheet)

Skills

Please circle the following professional areas in which you have had experience.

(You may have to display your abilities prior to employment)

Carpentry Landscape work Electrical appliances

Plumbing Road construction Automobile engine repair

Painting Excavating Welding

Glass repair Conservation Heavy-equipment operation

Woodworking Cement work Swimming Pool operation (built-in)

Roofing Refrigeration (Swamp cooler) Recordkeeping

Fire Control Logging (forestry) Metalwork

Water Well operation Animal control Sanitation

Canvas repair Small engine repair Facility Electrical work

Microsoft Office Hazardous Material Other- list below

Please circle the following interest fields in which you have experience.

Church activities Fire Department Veterans groups

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Employment

Have you ever been discharged or asked to resign from any job? Yes  No  (If yes, give details on separate sheet.)

1. Present or most recent employer. May we contact employer? Yes  No  If no, please explain why not:_______________________________________________________________________ Phone # (___) ____-______

Name of firm:__________________________From: Mo:______Yr.____ To: Mo:____Yr.____ Address:_____________________________City______________________State____________ Nature of firm’s business:_______________________________________________________________________ Supervisor Name (Mr./Mrs./Miss)_________________________________________________________________ Duties or responsbilities:__________________________________________________________________ ______________________________________________________________________________ Reason for leaving:________________________________________________________________________ 2. Next or most recent employer. May we contact employer? Yes  No  If no, please explain

why not:_______________________________________________________________________ Phone # (___) ____-______

Name of firm:__________________________From: Mo:______Yr.____ To: Mo:____Yr._____ Address:____________________________City______________________State_____________ Nature of firm’s business:_______________________________________________________________________ Supervisor Name (Mr./Mrs./Miss)_________________________________________________________________ Duties or responsbilities:__________________________________________________________________ ______________________________________________________________________________ Reason for leaving:________________________________________________________________________ 3. Next or most recent employer. May we contact employer? Yes  No  If no, please explain

why not:_______________________________________________________________________ Phone # (___) ____-______

Name of firm:__________________________From: Mo:______Yr.____ To: Mo:____Yr._____ Address:____________________________City______________________State_____________ Nature of firm’s

business:_______________________________________________________________________ Supervisor Name

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Objectives

The objectives of Scouting are, according to the charter and bylaws under which the movement operates, character development, citizenship training, and mental and physical fitness. Leaders and boys of all races and creeds subscribe to the Oath or Promise which reads in part: “On my honor I will do my duty to God and my country” and the 12th

point of the Scout Law which reads: “A Scout is reverent.” He is reverent towards God. He is faithful in his religious duties and respects the convictions of others in matter of custom and religion.

Do you, as a prospective employee, understand and accept these principles? Yes  No  You must become a registered member of the Boy Scouts of America prior to employment which includes a background check and completion of Youth Protection Training. I agree to complete the application: Yes  No 

I understand that the duties at Camp Don Harrington will include most, if not all weekends and some holiday work and no set hours: Yes  No 

I understand that I will be required to live on the Camp Ranger quarters located on Camp Don Harrington: Yes  No 

This position requires lifting (items over 50 pounds), moving, standing for long periods, sitting for long periods, working overhead, digging, working in hot/cold and inclement weather. Do you have any conditions that would prevent or limit you from performing these duties: Yes  No 

This position requires the ability to multi-task, plan, and organize work schedules and the ability to work unsupervised.

Applicants accepted for employment are on a temporary basis with a probationary period, and if in our judgment it is found this period that the employee is not adapted to the work assigned or that information given has been misrepresented, employment may be terminated without any other reason. The employee is an “exempt” employee which means he/she is exempt form Federal and State overtime laws.

I certify that, to the best of my knowledge given is complete and correct.

Date:_______Signature:______________________________________________ Applicants should not write below this line

References

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