Staff Application Form

Full legal First Name
Middle Initial
Last Name
Date of Birth
Cell Phone:
Email Address
Shirt Size
How did you hear about CMW?

Present Address


Permanent Address

Check here if address is the same as above.


High School
Years Completed
Years Completed


Do you have any experience as a camper?
If Yes When and Where?
Do you have any experience being a Counselor? 
If Yes When and Where?
Do you have any previous CMW experiences?
If yes, please explain

Date(s) Available

 Week 1: July 10 - 17
 Week 2: July 16 - 25
 Week 3: July 24 - 31
 Week 4: Aug 7 - 14
 Week 5: June 26 - July 3, 2021
 Week 6: July 5 - 10, 2021

Is there any reason you could not work a specific session? Or are you willing/able to work more than one session (non-consecutive)?
Position Desired (1st Choice)
Position Desired (2nd Choice)
Position Desired (3rd Choice)
Are you willing to be flexible and accepting of other duties/responsibilities if asked?
Would you be interested in becoming a speaker?
If Yes to the above?
Do you feel you have gained knowledge or experience in any area that would help you be an excellent CMW Staff Member?
Please list your educational and job experiences
List activities you participate in (school, professional, social, other groups)
Please describe your main interests
Why do you want to join Celebrate Me Week Staff?
What enables you to have a positive influence on 7th graders?
Write briefly on the importance of self-esteem:

Dietary Needs / Allergies

Please list any special dietary needs / allergies (if any):

References (Name, Phone/Email, Relationship)

Reference 1: 
Reference 2: 
Reference 3: 
Have you ever been convicted of a Felony crime?

 I have filled out this application to the very best of my ability and all of the information is honest and accurate. I understand that if accepted, I will be required to attend all staff trainings and fully dedicate myself to the week of CMW that I am staffing.

 If under 18, I have completed this form with a Parent/Guardian.
 I, hereby, agree to be photographed by CMW volunteer photographers during the session attended. Images may be used for future promotions.
 I understand that all applicants will be subject to a background check.

NOTE:  All applicants must join the CMW Staff page on Facebook to be considered. You will find the link on the next page after you apply.