Name*

Email*

Address* (Street, RR# Etc.)

Address (Apt.#, Unit# Etc.)

City*

Province/State

Country

Postal/Zip Code

Home Phone Number

Fax Number

Current Scouting Position*

Current District*

  I certify that I am currently a registered member of Scouting/Guiding
in my home country!

Date Of Birth*

Recruited By

Tee Shirt Size*

Please list below, any physical limitations or medical restrictions that would affect your placement within the different program areas at the Jamboree.
 

 Please list below, any special dietary needs.
 

Please check off any certifications that you now have, that would be of use to the Jamboree.
  Tripping Charge Certificate / ORCA
  St. John First Aid Instructor
  Medical/Dental Dr.
  Lifeguard-(NLS/Bronze Cross)

 Other, please specify
 

Please list any talents and interests that you have, that would be of use in Program Areas. Examples would be special displays, interest in edible plants, pioneering skills, languages other than English spoken fluently etc...
 

Please list any previous Great Lakes Jamboree or Wild Geese International Scoutoree experience that you have had.

List when were you at the Jamboree and or Wild Geese Scoutoree.


List where you worked at the Jamboree and or Wild Geese Scoutoree.

Please list any previous Jamboree or International Camporee Experience that you have had.
Please include your position on staff, if any, at these events.
 

Please indicate your preference for an area to work in.

 My First Choice Would Be...
  Please Assign Me As Needed Onsite Program Subcamp Staff Offsite Hike Program First Aid/Health Lodge Trading Post Kitchen Staff Security Staff Site Services (QM) Offsite Canoe Admin

 My Second Choice Would Be...
  Please Assign Me As Needed Onsite Program Subcamp Staff Offsite Hike Program First Aid/Health Lodge Trading Post Kitchen Staff Security Staff Site Services (QM) Offsite Canoe Admin

 My Third Choice Would Be...
  Please Assign Me As Needed Onsite Program Subcamp Staff Offsite Hike Program First Aid/Health Lodge Trading Post Kitchen Staff Security Staff Site Services (QM) Offsite Canoe Admin

Please Send Staff Fee To:
Carol Sanchioni
2519 Michigan Rd.,
Brights Grove, Ont.
N0N 1C0

Make cheques payable to:
Scouts Canada - Great Lakes Jamboree

Questions or More Info? Please contact Steve Locke
Phone: 519-383-7947

By sending this application, I accept The Great Lake Jamboree Staff Regulations.