Valley Mill Job Application - complete the form and click submit.

This is a contract position. You should be available to work June 9 – August 18, 2012.

any additional information can be e-mailed to: evelyn@valleymill.com

First Name		Last Name		DOB(Optional)
Street Address		City		State:
Zip Code:		Phone Number
e-mail Address		Cell Number
School Address		School Number
School City		School Zip
School State

How long have you lived at your address?	mo years
Previous Address ( in the past 10 years)
Do you have a drivers License?	yes no
Do you have a valid commercial drivers license?	yes no
Are you a U.S. citizen, or do you have the right to work in the U.S.?	yes no
Have you ever been convicted of a crime?	yes no
If yes state the offence, location and date of deposition
Are there any reasons you may have difficulty performing the essential functions of the job you are applying for?	yes no
If yes, please explain

	Education School and Location	From	To	Graduated	Major
High School				Yes No
College
Graduate School
Other
Military Service	Yes No
Discharge ?

In the following list check only those activities you can organize and teach.

Adventure Sports	Can Assistant Teach	Can Teach	Certified
Rock Climbing/ Rappelling
Rope Course
Sailing
Canoeing
Kayaking
First Aid Skills and Experience	Can Assistant Teach	Can Teach	Certified
CPR
FIRST AID
WILDERNESS FIRST AID
WILDERNESS FIRST RESPONDER
EMT
OUTDOOR LIVING SKILLS
OUTDOOR LIVING SKILLS
CAMPING
ORIENTEERING
OUTDOOR COOKING
NATURE
CAMP ACTIVITY SKILLS
HORSEBACK RIDING
AIR RIFLE
BASKETBALL
LIFEGUARDING
SYNCHRONIZED SWIMMING
GYMNASTICS
ARCHERY
MAINTENANCE SKILLS
AUTOMOBILE

What department do you see yourself working in?	Boys' Camp Girls' Camp
	Junior Camp
What position do you want at camp?
What contributions do you see yourself making to Valley Mill Camp?
I am available to work all 10 weeks	yes no
Any conflicts with the dates of camp orientation? June 9 - June 15
Work Experience (10 Years)
Start with the present and work backwards

(1)
Company Name		Your Title		Starting Salary
Company Address		City
State		Phone Number		Ending Salary
Date Started		Date Left

(2)
Company Name		Your Title		Starting Salary
Company Address		City
State		Phone Number		Ending Salary
Date Started		Date Left

(3)
Company Name		Your Title		Starting Salary
Company Address		City
State		Phone Number		Ending Salary
Date Started		Date Left

(4)
Company Name		Your Title		Starting Salary
Company Address		City
State		Phone Number		Ending Salary
Date Started		Date Left

Please Provide three references
Reference #1		Ref #1 Phone
Reference #2		Ref #2 Phone
Reference #3		Ref #3 Phone
Where did you hear about us?

Valley Mill is a drug free, smoke free workplace, we drug test all of our employees randomly.

I can comply to a drug free and smoke free environment yes no .

To contact us with any additional information please e-mail to evelyn@valleymill.com or call 301-948-0220.