EmailMe Form - Application

Name *

First Last

Date Time

MM / DD / YYYY

Address *

Street Address City State / Province / Region Postal / Zip Code

Email *

Phone *

### - ### - ####

Best method of contact *

Camper Experience

Please list your camper experience

	Camp name/State	Participation	Year	Sponsoring organization	Telephone number
1
2
3
4

Tell us about yourself. Please upload a letter that includes the following information:

Why are you applying to be an Apprentice? Describe your skills, special interests that would qualify you to be a part of this program. What can you contribute to the camp and campers? What does Camp Scherman mean to you.

Please upload this letter with this application. Once all the information has been received, you will be contacted to schedule an interview

Do you know of any reason why you would not be able to perform the essential functions on an Apprentice with or without reasonable accomodations? *

Yes

No

If you answered Yes, please describe:

Have you ever been convicted of a crime other than a traffic violation? *

Yes

No

If you answered Yes, please describe:

Date of conviction and location (a conviction will not necessarily be cause for disqualification):

Personal References:

List three people who can make a statement regarding your work experience, character and ability. Do not include relatives or friends. We must have reliable and current contact information - these are people to whom you will provide reference forms. Your signature on this application give us your permission to conact your references and/or employer(s)

First Last

Position/Company

Phone

### - ### - ####

Address

Street Address City State / Province / Region Postal / Zip Code

Name

First Last

Position/Company

Phone

### - ### - ####

Address

Street Address City State / Province / Region Postal / Zip Code

Name

First Last

Position/Company

Phone

### - ### - ####

Address

Street Address City State / Province / Region Postal / Zip Code

All Apprentices will be required to submit a physical examination record (taken within the 12 months) before the start of camp

Date

MM / DD / YYYY

Signature *

Clear