Application for Camp Ranger Golden Spread Council, BSA 401 Tascosa Rd. Amarillo, Texas 79124 www.goldenspread.org Office: 806-358-6500 Fax: 806-358-7470
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) Number of years in adult capacity: Adult positions held: Number year s youth experience: Cub Scout Boy Scout Venturing Explorer Highest Boy Scout Rank attained: 2
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 Civic groups Social clubs Conservation groups 3
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 Name of firm: From: Mo: Yr. To: Mo: Yr. Address: City State 2. Next or most recent employer. May we contact employer? Yes No If no, please explain Name of firm: From: Mo: Yr. To: Mo: Yr. Address: City State 3. Next or most recent employer. May we contact employer? Yes No If no, please explain Name of firm: From: Mo: Yr. To: Mo: Yr. Address: City State 4
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 12 th 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 5