2017 Summer Employment Application

C5 Georgia Mission - To transform the lives of high-potential teens from risk-filled environments, enabling them to lead themselves and their communities.

You will be part of a winning team of spirited college students, recent graduates and C5 staff and Alumni who are enthusiastic, committed, and dedicated to building a better future. Come ready to give it your all and to learn something new every day! Please email: employment@c5georgia.org or phone 678-293-4897 with any questions.

Thank you for applying to our organization!

C5 Georgia Program Team

Personal Information

Returning Staff Member *
Please Check *

Position and Source of Referral

Position Applying For:(Check all that apply) (For Descriptions of each Position please see C5 Georgia Summer Position Brochure ) *
Do you meet the minimum age requirements for the position(s) *
Where did you hear about us? (Click all that Apply) *


 Name of School and LocationYear GraduatedMajor & Course of Study
High School Or General Equivalency Diploma
Undergraduate College/ University
Are you currently a full time student? *


Please list relevant Camp or Youth Work Experience (paid or volunteer) first.

Have you even been dismissed or forced to resign from employment?

Training/ Certification

Indicate certifications/licenses you currently hold by checking the corresponding box.  (Proof of certification will be required)

Skills / Interest Areas

Please rate your proficiency in the following activities:
1 - No experience          
2 - Participated in Activity
3 - Qualified to assist
- Qualified to Teach/Lead
- Other information you would like to share
Leadership Activities
Community Service
Multicultural Programs
Conflict Resolution
Team-building Activities
Group Facilitation/Public Speaking
Curriculum Implementation
Other Leadership Skills & Interest
Outdoor living
Outdoor cooking
Fire Building
Wilderness Survival
Knot Tying/Lashing
Overnight Trips (Canoe, Backpacking)
Other Camping Skills & Interest
High Ropes Course
Low Ropes/ Teams Courses
Whitewater Rafting
Rock Climbing (Outdoors)
Leave No Trace
Other Camping Skills & Interest
Sports & Games
New Games
Team Initiatives
Other Sports/Games Skills & Interest
Expression, Arts and Performance
Singing/Song Leading
Dance/ Step
Newsletter or Creative Writing
Batik/Tie Dye
Candle Making
Marketing/Public Relations
Other Performance, Expression, or Art Skills & Interest
Miscellaneous but relevant experience.
Forest or Aquatic Ecology
Horseback Riding
Stargazing/ Astronomy
Quantity Cooking
Menu Planning
Program Planning
Campfire Program
Other Misc Skills & Interest
Do you have experience supervising children?
Do you have experience supervising Adults?

Description of Experience


Additional Information

Are you legally authorized to work in the United States? *
Are you able to perform the essential functions of the job positions for which you are applying with or without reasonable accommodation? *
Have you ever been convicted of a felony? *
Are you over the age of 21 with a valid Driver's License *
DMV records will be obtained and reviewed for employees for whom driving is a job responsibility. Do you have any moving violations or suspension(s) within the last three years on your driving record? *
I understand that I am applying for employment at the C5 Youth Foundation of Georgia d/b/a "C5" and "C5 Georgia". *
The information I have provided herein is correct and complete to the best of my knowledge. I understand that if I misrepresent or deliberately leave out a fact on my application, I may be refused employment, or, if employed I may be terminated. *
I authorize C5 to contact previous employers, except where otherwise noted, for references and to thoroughly investigate my educational background, past employment, and personal history/activities that may relate in any way to my fitness for employment with C5. I will not hold any official, staff or C5 representative liable for giving or receiving information with regard to this investigation. *
C5 is committed to providing a safe and healthy environment for campers, staff, and stakeholders. I agree to uphold a drug-free, alcohol-free and tobacco-free work and living environment that also prohibits the presence of any weapons or firearms anywhere on the premises. I understand that the foregoing extends to on and off campsite property and anytime during my employment with C5 Georgia. I am dedicated to being a role model for the youth of the C5 Georgia program. *
I understand and agree that my employment with C5 Georgia Youth Foundation is at-will. As such, I may terminate my employment at any time and C5 may terminate my contract for employment without notice or cause. I agree to abide by the rules and regulations of C5 and understand that no C5 official, agent or representative has any authority to enter into any agreement, verbal, written or otherwise, concerning length of employment, wages, benefits, or other conditions of employment beyond that agreement already executed. If terminated, C5 is only liable for wages earned up to and including the date of my termination. *
I understand and agree that I am required to take a drug test as a condition to employment for the purpose of determining my abilities to perform job duties now or in the future. I further understand that I am required to undergo a physical examination upon a conditional employment offer being extended. I agree to consent to take such tests at such time as determined by C5 and to release, waive and hold harmless, the C5 Youth Foundation of Georgia, its agents, representatives, heirs and assigns from any claims arising out of or in connection with the use of information resulting from such an examination. *
I understand that C5 is an Equal Opportunity Employer. No question on this application is used for the purpose of discrimination, limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state or federal law. *
C5 sets and expects the highest standards of behavior from all staff and youth participating in C5. I understand and agree that I am required to report any behavior that does not meet these standards immediately to the site director. These behaviors include, but are not limited to, sexual activity, drug and/or alcohol use, emotional concerns/issues, and physical concerns/issues among youth, staff, or between youth and staff. I understand that failure to report occurrences of the above behaviors may result in immediate termination of my employment. *
I have never been convicted on any charges related to abuse of any kind (physical, sexual, mental, emotional or otherwise). I understand that the C5 Youth Foundation of Georgia sets standards for its program to be free of any behaviors that resemble abuse of any definition. *

My signature indicates that I have read and agree to all of the certifications, authorizations and waivers listed above.