Counsellor In Training Application Form

First Name

Last Name

Address

Address Line 1

City

Province

Zip Code

Country

Phone (Home)

Phone (Mobile)

School You Are Attending

Current Grade/Level Completed

Experience: Have you previously volunteered or worked with children and/or youth?

Yes

If yes, please provide details (program, role, years of experience)

Interest in the CIT program: Why do you want to be a counsellor in training at summer camp?

Interest in the CIT program: What do you hope to learn or gain from this experience?

Skills & Qualifications: Please list any of your special skills, talents or interests (sports, arts, leadership, etc)

Skills & Qualifications: Please list any relevant training or courses (First Aid, Babysitting Course, Leadership training, etc)

Additional Information: Is there anything else you would like us to know about you?

Preferred Scheduling if you continue volunteering

Full days

Mornings

Afternoons

Post-CIT Volunteer Interest : If you are successfully accepted into and complete the CIT program, would you be interested in continuing as a Volunteer Summer Camp Assistant for the remainder of the summer? Candidates must be willing to volunteer at any of our 5 camp locations.

Yes, I would like to volunteer after completing CIT

Maybe – I’d like more information

No, I am not interested at this time

Specific days you are available (if known)

Certification & Signature: I certify that the information provided in this application is true and complete. I understand that any false information may result in removal from the Counsellor in Training (CIT) Program. I understand that references may be contacted and that a Vulnerable Sector Criminal Record Check will be required prior to participation.

Yes

Date

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone/Mobile