The Registration Process

nurses.campstaff.com

Here is the information we receive from camps.
Every item provided becomes part of your record. Some are strictly for administrative purposes, others appear on your CampStaffNurses Web page, and all are vital in helping nurses find your camp.

SAMPLE Camp Registration Form

Contact Information

Contact Name:      
Street Address:    1054 E 54th Street
City:               State:  Zip: 
Phone Number:      
FAX # (if any):    
Email (if any):

Camp Information

Camp Name:         
Street Address:    2 Emerson Street
City:               State:  Zip: 
Phone Number:      
Web Site (if any): 
Camper Age Range:   Size of Enrollment: 
Staff Start Date:  
Staff End Date:    
Salary Range:

Region: (Please select at least one)
West Coast (WA, OR, CA, HI, AK)
Southwest (NV, UT, CO, AZ, NM, TX)
Central (MT, ID, WY, ND, SD, NE, KS, OK)
Midwest (MN, WI, MI, IA, IL, IN, OH, MO)
New England (CT, MA, RI, NH, VT, ME)
Mid-Atlantic (NC, VA, WV, DC, MD, DE, PA, NJ, NY)
South (AR, TN, KY, LA, MS, AL, GA, FL, SC)
Canada

Type:
Sleep-Away Day

Gender Make-Up: (Please select one)
All Boys All Girls Co-Ed Brother/Sister

Specialty: (Please select at least one)

Academic Agency Arts Not-For-Profit Religious - Christian Religious - Jewish	Scout Special Needs Sports - General Sports - Specialty Traditional/None Travel
ACA Accredited

Health Care Staff Needed

Desired Certification(s):

CNA (Nursing Assistant)
Certified Athletic Trainer
Current Nursing Student
EMT (Emergency Medical Technician)
Graduate Nurse
LPN (Licensed Practical Nurse)
MA (Medical Assistant)

MD (Physician)
NP (Nurse Practioner)
PA (Physician's Assistant)
PT (Physical Therapist)
RN (Registered Nurse)
Student Athletic Trainer
WFA (Wilderness First Aid)

Are you only interested in profiles from staff of a certain gender?
Male Female No Preference

Brief Camp Description:

Camp Description For Health Care Staff:

Camp Description For Campers:

Next Page: How Nurses Find Your Camp

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