Summer Camp Counselor Application - International Soap Box Derby

Welcome

Thank you for your interest in applying for a Junior Staff position for the Soap Box Derby Summer Camp. Schedule a time to carefully complete, to sign (if under 18, parent/guardian’s signature is also required) and to submit this application during one session. Incomplete applications will not be saved to be completed later.

Application (Today's) Date*

MM slash DD slash YYYY

Please mark what days you are available from 8am - 3pm:*

Monday

Tuesday

Wednesday

Thursday

Friday

Soap Box Derby Summer Camp Junior Staff Experience

Name*

First Last

Gender*

Male

Female

Are you a returning Soap Box Derby Summer Camp counselor?*

Yes

Enter all years you served as a counselor:*

2023

2022

2021

2019

2018

2017

2016

2015

2014

2013

New Applicant

T-Shirt Size (Adult)*

XXL

Other

Birth Date*

MM slash DD slash YYYY

Age 18 or older as of June 1, 2023?*

Yes

Parent / Guardian's Name (if a minor)*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Grade in Fall, 2023*

8th Grade

9th Grade

10th Grade

11th Grade

12th Grade

College Student

Adult Counselor

School (if minor), or Place of Employment (if adult)*

Personal Information

Do you have any physical limitations?*

Yes

If you have physical limitations, please specify.

Do you have any allergies or other medical conditions?*

Yes

If you have allergies or other medical conditions, please specify.

Are you currently taking any medication?*

Yes

If you are taking medication, please specify.

Camp Experiences

Have you ever attended the Soap Box Derby Summer Camp?*

Yes

If yes, what did you like best about it?

Have you ever attended any other camps?*

Yes

If yes, list the Camps you attended. Briefly describe what you liked best about these Camps.

Employment Record

Have you held any jobs in the past? If so, please fill out the below information.*

Yes

Employer #1

Employer Name

Supervisor's Name

First Last

Phone

Location

Start and End Dates

Job Description

Employer #2

Employer Name

Supervisor's Name

First Last

Phone

Location

Start and End Dates

Job Description

Employer #2

Employer Name

Supervisor's Name

First Last

Phone

Location

Start and End Dates

Job Description

References

We highly recommend that you use professional references (teachers, professors, coaches, employers, youth leaders, etc.) for this application to speak about your personal character and abilities. We require that at least one of three required references to be a professional reference.

Reference Type*

Personal

Professional

Name*

First Last

Organization*

Title or Position*

Number of Years Known*

Please enter a number from 1 to 100.

Relationship*

Email*

Phone*

Reference #2

Reference Type*

Personal

Professional

Name*

First Last

Organization*

Title or Position*

Number of Years Known*

Please enter a number from 1 to 100.

Relationship*

Email*

Phone*

Reference #3

Reference Type*

Personal

Professional

Name*

First Last

Organization*

Title or Position*

Number of Years Known*

Please enter a number from 1 to 100.

Relationship*

Email*

Phone*

Application Questions

Please take your time in filling out the following questions. The answers to these questions may set you apart from the other applicants and highly impact interview consideration.

Please explain any training, experience, interests, or skills that would contribute to your role as a counselor at the Soap Box Derby Summer Camp.*

Why do you want to be a counselor for the Soap Box Derby Summer Camp?*

What do you consider to be the most important role(s) you will have as a counselor? How will you use your role to impact the overall Summer Camp experience for the campers?*

What personal and career skills would you like to develop as a result of being a counselor for the Soap Box Derby Summer Camp?*

What future goals would you like to pursue after high school? (if a minor)*

Authorization to Check Applicant's Statement

I certify that the information provided on this application (and any accompanying resume, if any) is true and complete to the best of my knowledge. I hereby attest that I am the legal parent/guardian of the above-named child and hereby consent to my child submitting this application for review and consideration for the volunteer Junior Staff member position being offered through the Soap Box Derby’s Summer Camp.

Applicant's Signature*

Date*

MM slash DD slash YYYY

Parent / Guardian Signature*

Date*

MM slash DD slash YYYY

Summer Camp
Counselor Application

Welcome

Soap Box Derby Summer Camp Junior Staff Experience

Personal Information

Camp Experiences

Employment Record

References

Application Questions

Authorization to Check Applicant's Statement

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