Please make sure you have read and understood our pricing policy before you register.
Required Fields Are Marked In Red

Contact Information

Contact Name:
Street Address:
City:
State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other American Territory Canada - Alberta Canada - British Columbia Canada - Manitoba Canada - New Brunswick Canada - Newfoundland Canada - Nova Scotia Canada - Northwest Territories Canada - Ontario Canada - Prince Edward Island Canada - Quebec Canada - Saskatchwan Canada - Yukon Zip:
Phone Number:
FAX # (if any):
Email:

Camp Information

Camp Name:
Street Address:
City:
State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other American Territory Canada - Alberta Canada - British Columbia Canada - Manitoba Canada - New Brunswick Canada - Newfoundland Canada - Nova Scotia Canada - Northwest Territories Canada - Ontario Canada - Prince Edward Island Canada - Quebec Canada - Saskatchwan Canada - Yukon Zip:
Phone Number:
Web Site (if any):	Please include "http://"
Camper Age Range:
Size of Enrollment:	Size of Staff:
Staff Start Date:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , 2010
Staff End Date:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , 2010
Salary Range:
	(Assuming the job candidate brings no children to camp)

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 (VA, WV, DC, MD, DE, PA, NJ, NY)
South (AR, TN, KY, LA, MS, AL, GA, FL, SC, NC)
Canada

Type: (Please select at least one)
Sleep-Away Day

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

Your Camp's Gender Make-Up: (Please select at least one)
All Boys All Girls Co-Ed Brother/Sister Camps

Camp Specialty: (Please select at least one and all that apply)
Academic
Agency
Arts
Not-For-Profit
Private
Religious - Christian
Religious - Jewish
Scout
Special Needs
Sports - General
Sports - Specialty
Traditional / None
Travel
ACA Accredited (If checked, please select your ACA Section below.)

If your camp is ACA Accredited, please select the ACA Section to which you belong:
Not ACA Accredited ACA Chesapeake Section ACA Coronado Section ACA Evergreen Section ACA Great Rivers Section ACA Heart of the South Section ACA Illinois Section ACA Indiana Section ACA Keystone Section ACA Michigan Section ACA New England Section ACA New Jersey Section ACA New York Section ACA Northern California Section ACA Northland Section ACA Ohio Section ACA Oregon Trail Section ACA Rocky Mountain Section ACA Southeastern Section ACA Southern California Section ACA St. Louis Section ACA Texoma Section ACA Upstate New York Section ACA Virginias Section ACA Wisconsin Section

Brief Camp Description -- MAXIMUM 50 WORDS:


Full Camp Description for Prospective Staff:


Camp Description for Campers (in case staff member is a parent):


Featured Activities for Campers:


Other Activities for Campers:


Session Length(s) for Campers:


Camper Tuition: Select Tuition Range Less than $400 per week $400 to $600 per week $600 to $800 dollars per week More than $800 per week

Desired Certification(s) for Health Care Staff

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)

Other: (Use this space to list specific health care staffing needs and conditions, or to explain choices you made above)


Please invent a username:

Note: Username should apply to your camp in general, not an individual employee.

Please invent a password, and enter it twice (make sure they match):

Please indicate your desired service contract:

One hiring season at $250

or