Roman Catholic 
Diocese of Ogdensburg

New Staff Application

General

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Education
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Program Areas of Special Interest
At Camp Guggenheim, staff members are part of a team. A staff member’s willingness to help out with virtually all aspects of camp living is important to our lives as a community. Staff members are typically given primary responsibilities in one of the following areas. Please indicate the areas that you are interested in working in, and identify your preferences by numbering your choices in sequence (1st, 2nd, 3rd, etc.)
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Certifications:
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Please indicate the date issued and the License Number in the space provided if you obtain one of the following:
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Note: Annual recertification in CPR is needed to maintain current Lifeguarding and RTE certification.

Summer Camp Experience:
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References
Give the names and addresses of three people other than relatives and peers who have knowledge of your ability to work with teenagers and your character. Please include Title, Address and Phone for each Reference. Please include your Campus Minister or your Pastor in this list. Please ask each of these people to write a letter of recommendation for you and forward it under separate cover to: Office of Youth Ministry, P.O. Box 369, Ogdensburg, NY 13669 by March 1.
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Employment:
Please provide up to 3 employers. Please list the dates employed, contact person, address, phone and type of work.
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NOTIFICATION AND AGREEMENT Please read before signing I certify that all answers given by me are true, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts on this application (or any other accompanying documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered. It is the policy of the Diocese of Ogdensburg to afford equal opportunity to all employees and applicants for employment without regard to age, race, color, sex, national origin, marital status, disability, veteran status, religion (except when deemed necessary to fulfill job obligations of the Diocese of Ogdensburg) or any other status protected by law. I understand that if offered a position with the Diocese of Ogdensburg, I will be required to submit a background check as condition of employment. As set forth in Canon Law and the code of Pastoral Conduct of the Diocese (Section 6), the Diocese and any agencies employed by it will maintain confidentiality in creating, storing, accessing, transferring and disposing of background checks authorized by this document and all reports, papers and information relating to such background checks. The Diocese will use all information obtained for no purpose other than conducting background checks on the undersigned. Questions regarding this statement should be directed to the employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed. By signing below I acknowledge that I have read, understood and agree to the above statements.
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(By typing your full name in the Person Applying Box above you certify that everything you entered in this form is true and that you understand what is being asked of you.)