<b>Swimming</b><br />Daily Swimming, Beginner Swim Instruction, Free Swim, Pool Slides and More! <b>Sports</b><br />Basketball, Football, Floor Hockey, Volleyball, Dodgeball, Gaga Ball, Newcombe, Handball, Soccer, Baseball, Kickball & Many More! <b>Facilities</b><br />Outdoor Pool - 3 Pool Slides, All Sports Courts, Television Studio, Karaoke, Arts & Crafts, Computer Labs, Video Game Room, Circus, Jungle Gym, Children's Playground, Baking Center, Movie Theatres, Dance Studios, Drama Theatre & More! <b>The Arts</b><br />Dance, Music, Drama, Talent Shows, Color War Arts & Crafts & Magic <b>Air Conditioned Buses</b><br />All camp vehicles used for daily transportation and trips are air condition and seat belt equipped! <b>Trips</b><br />Day Trips & Overnight Trips to the best and most popular camper friendly destinations! <b>Programs</b><br />5 unique programs designed specifically for children and teens ages 2 to 14 years old. <b>Mission</b><br />Our goal is to provide every child who attends camp and every staff member a summer filled with memories and friends they will remember forever.
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Mill Basin Day Camp
Online Employment Application
(All information submitted is property of Mill Basin Day Camp, Inc.)
Position Applying For:*
Age Group Preference:*
First name:*
Last name:*
Gender:*
Date of Birth:* (dd/mm/yy)
Age:*
Social Security #:*
Home Address:*
Apt:
City:*
State:*
Zip:*
Home phone:*
Cell Phone:
Email:*
Verify Email:*
Summer Youth Employment Number:
Provider (COJO or NSHDS):
Emergency contact:*
Emergency phone:*
Additional Position Applying For: Head Bus Counselor
 (Minimum 16 Years Old. Must be able to be the first to be picked up each morning and last to be dropped off each evening. Will be picked up and dropped off at home by bus daily.)
  Assistant Bus Counselor
Assistant to head counselor. Must be able to be the first to be picked up each morning and last to be dropped off each evening. Will be picked up and dropped off at home by bus daily.
  Early Morning Staff
Must arrive at 7:15 AM each morning. Early morning staff will take attendance and supervise campers until 8:30 am.
  Late Stay Staff
Must be able to work from 4:30 to 6:30 each evening. Late stay staff will take attendance and supervise camper activities.
Education  
School:*
Course:
Years Completed:*
Degree/Diploma:*
Name of School:*
School Phone:*
Work Experience Please provide accurate, full time and part time employment records. Start with your present or most recent employer. Please note that employment information and/or references will be checked and may be used to determine your employment qualifications.
Company Name:
Address:
Phone:
Name of Supervisor:
Employed From (mm/yy):
Employed To (mm/yy):
Job Title/Responsibilities:
Salary: $:
Reason No Longer There:
Company Name:
Address:
Phone:
Name of Supervisor:
Employed From (mm/yy):
Employed To (mm/yy):
Job Title/Responsibilities:
Salary:
Reason No Longer There:
Company Name:
Address:
Phone:
Name of Supervisor:
Employed From (mm/yy):
Employed To (mm/yy):
Job Title/Responsibilities
Salary: $:
Reason No Longer There:
References Please list 3 adults that are non relatives who can and will be contacted regarding your ability and experience. This information is required by ALL applicants including returning staff. No application will be reviewed without it.
Reference Name:*
Contact Phone:*
Relationship:*
Reference Name:*
Contact Phone:*
Relationship:*
Reference Name:*
Contact Phone:*
Relationship:*
Certifications Click all that apply
Driver's License RN CPR WSI First Aid Life Guard Training RTE EMT Other
Additional Information:
Physical limitations, membership in professional and or civic organizations, clubs or groups. Special
accomplishments, merits, awards, etc.
Background Check (criminal) Misdemeanors / Felonies
Have you been convicted of any misdemeanors?:*
If Yes, Please Explain:
Have you ever been convicted of a Felony? *
If Yes, Please Explain:
Have you ever been convicted of a Sex Crime? *
If Yes, Please Explain:
Activities Please check all activities you feel you can instruct or assist an instructor
Arts & Crafts Computers Sports Video Dance Photography Drama Baking Music Swimming
Science/Nature Group Games Karate/Martial Arts Other
Do you have any other special skills that may enhance our camper's experience? Also Let us know why you feel you would make a good addition to our staff:
Prospective employees will receive consideration without discrimination based on race, creed, color, religion, sex, age, national origin, handicap, veteran status or any condition prescribed by law. Mill Basin Day Camp is and equal opportunity employer.
PLEASE READ AND UNDERSTAND THIS STATEMENT BEFORE SIGNING THIS APPLICATION. THOSE UNDER THE AGE OF 18 MUST HAVE THEIR PARENT OR LEGAL GUARDIAN READ AND SIGN AS WELL. NO APPLICATION WILL BE GIVEN CONSIDERATION WITHOUT ALL NECESSARY SIGNATURES OR REQUESTED INFORMATION. PLEASE NOTE THAT SUBMITTING AN APPLICATION AND/OR RECEIVING AN INTERVIEW IS NOT A GUARANTEE FOR JOB PLACEMENT.
The information I have provided in this Employment Application is true, correct and complete. False, incomplete or misrepresented information of any kind, will be sufficient cause for this application to be rejected or, if discovered after I am employed, case for immediate termination of employment without due compensation.
I authorize the employer to contact and obtain information about me from previous employers, educational institutions, law enforcement, government agencies and references that were or were not provided and any other party necessary to verify the accuracy of information disclosed in this application, a related employment resume or a personal interview. To assist in the processing of my application, I waive all rights and claims I may otherwise have against the employer or its current representatives, for seeking and using information to evaluate my employment request and all other persons, corporations or organizations who provide information for this purpose.
This application is not an employment agreement or contract. If I accept an offer of employment I understand my employer may terminate my employment at any time, with or without cause, with or without prior notice, unless required by law. I understand that no one, other than an executive officer of the employer, has authority to enter into an employment agreement with terms contrary to the forgoing and then only in writing signed by that officer.
I FULLY UNDERSTAND AND ACCEPT ALL TERMS AND CONDITIONS IN THE ABOVE STATEMENT.
Name (please type your name in full):*
Date:*
 

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5945 Strickland Ave - Brooklyn, NY 11234 - 718.251.6200
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