Math, Science, and Technology Camp
Staff/Instructor Application




Email Address (SENDER) (You must provide a valid email address)

Position you are applying for: Position

Gender: Male Female


Name of High School or College GPA

Street Address

City State Zip

Local Phone

Cell Phone


Name of Parent(s)

Parent's Address

City State Zip

Are you a vegetarian? Yes No

1. Why do you want to be a Staff Leader or Instructor for the camp?

2. List any classes/jobs/activities/experiences you have been involved in and discuss how they may help you as a camp leader or instructor.

3. Which is your favorite, math or science? Why?

4.Describe a fun math or science lesson that could be used with approsimately 30 middle school students. State objectives, goals, materials needed and description of lesson.

5. List name, addresses and phone number of two references.

6. All prospective candidates must go through a 10 to 20 minute phone interview. Please list dates and times you will be available between June 3-10, 2013, 6:00 pm - 8:00 pm.
1st choice

2nd choice

3rd choice.

Note: All hired staff will be expected to attend staff training Saturday, July 6, 2013.