Sample Page Name* First Last Social Security Number*Home Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone*Home Phone or Secondary Contact NumberDate of Birth* MM DD YYYY Email* Position Applying For:*General/Activities StaffMaintenance CrewLifeguardKitchen StaffPhotographerAre you available for Weekend Shifts? (Check all that apply) May June July August September Are you available for weekday shifts in May and June?YesNoHave you previously worked at Black Bear Lake Camp or Picnics? If so, when?Educational Background High SchoolDates AttendedSchoolDegree CollegeDates AttendedSchoolMajorDegree OtherDates AttendedSchoolMajorDegreePast EmploymentList 3 most recent jobs. Employment Details 1Dates of EmploymentCompany NameAddress/PhoneResponsibilitiesSupervisorReason for Leaving Employment Details 2Dates of EmploymentCompany NameAddress/PhoneResponsibilitiesSupervisorReason for Leaving Employment Details 3Dates of EmploymentCompany NameAddress/PhoneResponsibilitiesSupervisorReason for LeavingReferences2 persons (not personal friends or relatives) having knowledge of your character, experience, and ability. Reference 1Name First Last RelationshipContact Number Reference 2Name First Last RelationshipContact Number