Summer Staff Application

Employee Information

Legal First Name *
Middle Initial *
Last Name *
First Name Used *

Date of Birth mm/dd/yyyy *
Gender
School Grade
Current School Grade (or just completed) *
Name of School (if attending)
School Major

SSN ###-##-#### *
Drivers License Number
Are you married?
Spouse's Name

Contact Information

Home Address
Address *
Address is in the United States? Yes No
City *
State *
Zip *
Country *

School Address (if living away from home)
Address
Address is in the United States? Yes No
City
State
Zip
Country

Phone
Cell Phone Number *

Email
Email *

Parent 1 Information
Father's Name
Dad Cell Phone Number

Parent 2 Information
Mother's Name
Mom Cell Phone Number

Additional Information

This will be my

summer at Camp Longhorn.

I was recommended by

How did you hear about Camp Longhorn?

Who do you know that is or has attended Camp Longhorn?

Camps Previously Attended

Clubs, Teams or Social Organizations you're a member of

Other Skills

Do you use Tobacco?

No Yes

Do you use illegal drugs?

No Yes

Have you ever been convicted of a crime or convicted of any child molestation or abuse offense?

No Yes

If you answered yes, please provide details.

References

New Applicants need 2 references: Must be 18 (teacher, coach, employer, religious leader, supervisor)

Reference One
Name *
Address *
City *
State *
Zip *
Relation *
Email *
Phone Number *

Reference Two
Name *
Address *
City *
State
Zip *
Relation *
Email *
Phone Number *

Please be advised that Camp Longhorn has a policy of no drugs, alcohol or tobacco use of any form while at Camp. Violation of this policy is cause for dismissal. Camp Longhorn counselors are expected to comply with Camp’s dress and conduct codes.

By submitting this application, applicant acknowledges that Camp Longhorn may verify references. A background check required by Texas Law, will be run prior to employment.

I verify that all the information provided is correct.