Wildlife Safari Summer Camp 
Counselor-In-Training Application




Name __________________________________  Birthdate  _______  Grade  _______ 

Address________________________________________________________________

Phone_____________ E-mail__________________

Present Occupation___________________________ Soc Sec #__________________ 

References: (No family members, please. Teachers, coaches are great!.)

1.  Name: ___________________________   Phone:   _____________

Description of Relationship:  ____________________________________________
 

2.  Name: ___________________________________   Phone:  ________________

Description of Relationship:  _____________________________________________

Please briefly answer the following questions on a separate sheet of paper to help us get to know you better.

  • What do you hope to gain from participating in this program?
  • Have you ever had a leadership position at a camp (counselor, lifeguard, etc.)? If so, with what age did you work? What skills did you acquire? Describe your experience.
  • What special skills, experience, or talents can you bring to your group of campers, fellow CITÂ’s and counselors?
  • Describe your interest and background in environmental education.
  • Describe any other previous job and volunteer experience.
  • Are you able to attend the training meetings, held from 9 am-1 pm on July 19 and 22? 

I, ________________________, verify that all the information provided is true and correct.

Signature of applicant:  ________________________________    Date:  _______

Signature of parent or guardian  ____________________________  Date: _______ 
 
 

Thank you for your application. Mail completed applications to: Safari Summer Camp
                                                                                                            Wildlife Safari
                                                                                                            PO Box 1600
                                                                                                            Winston, OR 97496

Applications must be received by 5:00 pm on June 10, 2002 to be considered.

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