Summer Prevention Program

Celebrating 20 Years of Service!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Text Box: Sunshine Prevention Center for Youth & Families
468 Boyle Road  Port Jefferson Station, NY. 11776

Please print, fill out, and send to Sunshine or bring with you

Summer Positions 2013 Application Form

ALL STAFF WILL BE SUBJECT TO RANDOM DRUG TESTING

 

Name ________________________________________    Date __________________

 

Address ______________________________________________________________

 

Town __________________________     State ________        Zip ________________

 

Phone _______________  Cell phone  ________________  Email ________________

 

Other # where you can be reached ____________________________________

 

Social Security # ____________________    Driver’s License ___________________

 

What age group are you interested working w/     _____ 4 – 11       _____ 12 & up

 

Are you seeking an internship or volunteer position?

 

What are your available days, hours ________________________________________

 

Is there any days/weeks this year you know you can not work or will be late or leave early due to previous commitment? Give all dates now ___________________

______________________________________________________________________

 

Are you applying for a non-paid internship _______ volunteer position  ______   

 

(college students) # of hours you must complete _____  by when _________________

 

Paid position Salary Expected    $__________ per hour  $___________ per week

Have you been fingerprinted or completed a back ground check from any previous employer?___

Are you CPR, First Aide or Life Guard Certified? ________________________________________

 

Explain Previous Experience: 

 

Explain Previous Education:

 

List and certifications:

 

List any credentials:

 

List any awards:

To contact us:

Sunshine Summer Positions 2013 Application Form