Full Name     

Name Used 

Home Address

City  State  Zip

Home Phone # Cell Phone #

Date-Of-Birth Age    Religion    

E-mail        

College Name    Major

College Address 

City  State  Zip Ph#

Check One: Freshman    Sophomore    Junior    Senior

Social Security #   Sorority

Have you attended Camp Mystic before?      Yes    No

Who told you about Mystic? 

Please list other camps you've attended or been employed by

Please fill in your top 5 activity choices.  Also check willing and/or experienced as they apply.  Activities marked with an "*" are our hardest to fill. Please choose at least 2 of those activities.   Click here to view activity descriptions.

1st Activity Choice  2nd Activity Choice 

3rd Activity Choice 4th Activity Choice  

5th Activity Choice

                                                                      WILLING           EXPERIENCED                                                                       WILLING     EXPERIENCED

**WATERFRONT SIGN-UP

Sign me up for life-guard &/or waterfront training at Mystic in late May.

Yes   No

CHECK IF YOU HOLD: WSIEWSLifeguard Mystic W.F. Training

**HORSEBACK RIDING SIGN-UP

 Sign me up for the riding clinic at Mystic in late May.

Yes   No

Please check if you are currently certified

First Aid         CPR

OTHER POSITIONS AVAILABLE WITHOUT CABIN DUTY AND PAID ON A HIGHER SCALE:  Please check if you can serve as a: 

bookkeeper      secretary         food preparation assistant

nurse’s helper      store manager          babysitter

Musical instruments you play

CHECK THE TERM (S) YOU WISH TO SERVE AS A COUNSELOR:

(we recommend only 1 or 2 terms)

(All dates include counselor orientation)

What age girls would you prefer in your cabin?

JUNIORS (7-10)     INTERMEDIATES (11-13)    SENIORS (14-17)  

Please give at least 3 names and full addresses with zip codes for references: a teacher, resident of your home community, director of a camp, or an employer.

Will you give Camp Mystic permission to check your references and  background?  Yes   No

We are dedicated to creating a healthy environment for our campers and employees.  To help us accomplish this goal at Camp Mystic, we need employees who are dedicated toward this objective.

Please check the word which best describes YOUR personal views on the following subjects:

(indicate how YOU stand and NOT the way you feel toward others)

DRINKING ALCOHOLIC BEVERAGES

Avoid   Sinful   Acceptable for others only  

OK if of age   Personally acceptable 

Comment

SMOKING

Avoid    Sinful    Acceptable for others only    Personally acceptable Comment

ILLEGAL DRUGS

Avoid    Sinful    Acceptable for others only    Personally acceptable Comment

HOMOSEXUALITY

Avoid    Sinful    Acceptable for others only    Personally acceptable Comment

TATTOOS & BODY PIERCING

Avoid    Sinful    Acceptable for others only    Personally acceptable Comment

Have you ever been arrested?    Yes   No

Camp Mystic has a no smoking policy on camp grounds.  Will you be able to comply?  Yes   No

Counselors are not allowed to consume alcoholic beverages on or off the camp grounds while under contract.  Will you be able to comply with this policy?

Yes   No

What honors have you received while in schools or camps?

What opportunities have you had to work with children?

What role has Christianity played in your life?

If you are hired and sign a contract this spring, do you consider your signature and word binding?           Yes      No 

What circumstances might prevent you from fulfilling a contract?

What expectations do you have as a camp counselor?

What sincere contribution could you make to Mystic? What personal goals would you set for the summer?