| First name:
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| Last name:
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| Address:
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| Postal Code: |
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Home Phone: |
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Work Phone: |
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Email: |
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Gender: |
Male
Female |
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Age on August 1, 2008: |
16-17
18-20
21 or over |
Current Registered
Position in Scouting: |
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Scout Association (if not Boy Scouts of America): |
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Scouting Experience (including positions held and how long, long-term
camping experience, jamborees, etc.) |
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Youth Protection Training: |
Completed since August 2006
Plan to Complete by July 2008 |
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Scout Training Courses Completed: |
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Special Training or Certification (waterfront, rifle, etc.): |
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Useful Trade/Skill/Hobbies: |
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Languages other than English spoken: |
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International Experiences: |
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Commercial Driver’s License (CDL), include Class & Endorsements: |
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| I wish to be considered for a position in the following areas: |
1st choice:
2nd choice:
3rd choice:
Other: |
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Camp Housing Preferences: |
Bunk in Staff Cabin
Own Tent
Own Camper/Trailer
Please note: No in-camp automobile parking
will be available. |
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I understand that all staff
members must:
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be active registered Scouts
or Scouters at the time of application and on July 30, 2008
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have completed Youth
Protection Training by that date
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agree to follow the staff
guidelines, and
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present at the MIC an
up-to-date BSA Personal Health and Medical Record (or equivalent) signed
by a doctor (Class 1 and Class 2 for those under age 40, Class 3 for
those 40 and older).
I also understand that all
Michigan staff members will be expected to attend an orientation and site
inspection weekend at Northwoods in April, 2008 and all staff members will
be at Northwoods from Saturday, July 26 to Sunday August 3, 2008 for the
Camporee. I will submit my staff application electronically as
instructed on the Michigan International Camporee
web site and mail in a paper version with a $100 staff fee to cover the
cost of staff meals and camporee items. In accordance with Youth
Protection, the council office of each U.S. staff applicant and
International Commissioner of each international staff applicant will be
contacted to verify the applicant’s qualifications. This fee will be
refunded to anyone not selected to be on the MIC staff. |
| Council Information (for U.S. and Canadian Applicants) |
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Name: |
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| Address:
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Phone: |
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