Camp Counselor Application - Office for Diversity & Health Equity

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Please identify the three people you requested to send a recommendation letter <strong>for</strong> you.Name________________________________ Telephone_______________ Email:_________________Address___________________________________________________________City, State, Zip______________________________________________________How long have you known current reference? _________________________________What is your relationship to the person giving the reference? ______________________Name________________________________ Telephone________________ Email:________________Address ___________________________________________________________City, State, Zip_______________________________________________________How long have you known current reference? __________________________________What is your relationship to the person giving the reference? _______________________Name________________________________ Telephone_________________ Email:_______________Address___________________________________________________________City, State, Zip______________________________________________________How long have you known current reference? _________________________________What is your relationship to the person giving the reference? _______________________Have you ever been convicted of a felony? ____Yes ____NoHave you pleaded nolo contendere (no contest) to, been convicted or found guilty (even ifadjudication withheld) of a felony offense <strong>for</strong> the sale, trafficking, or conspiracy to sell ortraffic a controlled substance committed on or after October 1, 1990, as defined in Chapter893, Florida Statute? ____Yes ____No7
Page 1 and 2: DEADLINE is May 10, 2013HEALTH CARE
Page 3 and 4: VIII.Work HoursA. All CC’s are ex
Page 5: EXTRA-CURRICULAR ACTIVITIES: List a

Camp Counselor Application - Office for Diversity & Health Equity

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