RETURNING 4-H Camp Counselor Application
Applications Due Jan 1 (midnight)
Camp Dates:  June 7-10

Attach a short letter of support from a reference who can tell us about how you have worked or would work with youth.  This person should not be a parent. (It could be a youth group leader, teacher, club leader, or leader in a religious organization.) In the letter, please have them address the following:  Leadership experience, experience working with youth, & handling responsibility.

Camp counselors MUST participate in camp counselor training.  We will have two zoom trainings plus an in-person training May 6-7 & June 6.  

Applicants will be interviewed via zoom in January.

If you have questions, please contact Clark or Eau Claire County Educators.
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Correo *
First Name *
Last Name *
Address *
City & Zip *
Parent E-mail *
Youth E-mail *
Youth Phone *
Parent Phone *
What grade are you in?
Please check all those you are currently certified in *
Obligatorio
Please describe any special dietary needs
What is an area of growth for you at summer 4-H camp in 2023? *
What is a goal that you have for 4-H summer camp 2023? *
YOU TAKE THE LEAD Identify an activity you will facilitate at camp in 2023 (Answer in the next session)
1. Activity:
2. Which camps will you facilitate this activity with:
3. Supplies Needed:
4. Amount of Preparation time:
5. Amount of Facilitation time:
6. What is the goal of this activity:
7. What are the outcomes of this activity (what skills do you want the campers to gain by participating in this activity:            
8. State step by step directions (use another sheet of paper as needed):      
                                                             
Please share as many details as possible to ensure another counselor could pick up this piece of paper and facilitate the activity in your place.


Please answer the above prompt here. (Tip: You may want to type this is a Google Doc or Microsoft to account for any grammatical errors.) *
What size t-shirt do you prefer? (Adult Size)   *
I understand that camp counselors MUST participate in camp counselor training.  Some trainings will be virtual via zoom (dates TBD.)  Some training will be in person (May 6-7 & June 6.)  Successful completion of these trainings is required for participation as a counselor. 
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Before submitting please make sure have check grammar and spelling. It is alright to type your answers in another document and copy and paste your answers to this form.
If you have any questions about this form please call Clark County Office @ 715-743-5122 or Eau Claire Office @ 715-839-4712.
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