Camp Counselor Application

Champaign/Logan County Camp
2005 Counselor/Counselor-in-Training Application

Requirements to be considered a Counselor or CIT:
Must currently be in the 9th - 12th grade
Attend training sessions - any missed must be excused in advance and required to be made up

Scheduled meeting dates and times:
Monday, March 14                6-9 PM        Champaign Co. OSUE Office
Tuesday, April 5                6-9 PM        Champaign Co. OSUE Office
Monday, April 25             6-9 PM        Champaign Co. OSUE Office
Monday, May 9     6-9 PM         Champaign Co. OSUE Office
Tuesday, May 31     6-9 PM        Champaign Co. OSUE Office

A meeting at Camp Clifton will be scheduled in the spring. Details will be given at meetings.

Date Submitted                                      20                      County

Name                                                                                                Phone

Address                                                                                                                      Boy (   )    Girl (    )

City                                                                                   Zip                        Years in 4-H

Your age on January 1st, 2005                                       Date of birth

Grade in school                                           School you attend

I would like to be a Counselor/CIT at the following camp(s):    Please check your choice below

            Camp #1 ONLY (June 28-July 2, 2005)    Note: this is a five day camp

            Camp #2 ONLY (July 9-13, 2005)    Note: this is a five day camp

            No Preference - Either one of the camps is acceptable

Note: It may be necessary to assign a counselor to a camp other than their choice (a last resort).

A. Experience

1. Camping Experience:
Camp What years?

2. Camp Counselor/C.I.T. Experience:

Camp What Years? Areas worked with?

3. Check if you have had training in:
First Aid CPR Peer Counseling Recreation Leadership

B. Camp Planning

1. What camping area(s) would you be willing to take responsibility for? Check all that apply.

    ASE Course                            Recreational Dancing                        Flags
    Nature Education                    Vespers                                           Crafts
    Song Leading                           Organized Sports                            Wide Game
   Campfire                                Rocketry                                        Special Skills Workshop
Camp Newspaper                    Sports Workshop Archery
Bicycling "Rap-on-Life" Skits & Drama
Team Challenge Pool Games Water Games
Photography    Cooking Workshop Art Workshop
Canoeing                                   Fitness/Aerobics

List any other activities not listed above that you would be willing to work with:

2. List two suggestions as possible themes for camp:

    a.

    b.

C. What would you do?

1. You have a camper in your cabin that does not join in conversation with the other campers and has a sad face. The camper says he/she does not feel well and wants to go home. What would you do about it?

2. You get woke up at 6:00 a.m. by campers coming in and out of your cabin door. From the conversation, you learn that they have been out putting shaving cream on the neighboring cabins. What would you do?

D. Skills and Talents

1. What talents and skills do you possess that would be helpful to the camping program?











Note: Briefly write why you wish to be a camp counselor and how you would benefit the 4-H camping program. What have you learned as a camper and 4-H'er that would help you be a good counselor. Use back of form, if needed.













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