2020 Application

Employment Application

PERSONAL INFORMATION

Address
City
State/Province
Zip/Postal

POSITION/AVAILABILITY (include resume if applying as instructor)

Drop a file here or click to upload Choose File
Maximum upload size: 33.55MB
Check the weeks you are available. (Instructors MUST be available for all 5 weeks. Counselors and Jr. Counselors must be available for 2 weeks minimum; 3 weeks required to be eligible for a scholarship.)
(NYSS encourages employees to participate in classes when possible.)

Skills and Qualifications

Check all of these that apply. Include date of certification & certification number, if applicable, & date of expiration.
NoYes
NoYes
NoYes
NoYes
NoYes

LEGAL HISTORY

NoYes

EMERGENCY CONTACT INFO

MEDICAL HISTORY

NoYes
I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.