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Polk Soil & Water Conservation District

Outdoor School (ODS)

New Counselor Application 2013 Outdoor School (ODS) is a 3-day 2-night natural resources educational program put on by the Polk Soil & Water Conservation District. 6th-grade students from Polk County, along with teachers, volunteers, instructors, Polk SWCD staff and directors attend this event. The first session of Outdoor School this year is: Wednesday March 13th through Friday March 15th, 2013 High School Counselors play a vital role in making the program a success. Counselors have direct contact with the 6th grade students on a daily basis, including eating, attending Outdoor School sessions, recreation and participating with the students in a variety of other activities. Counselors can make or break a child’s experience; therefore, we only accept qualified, energetic, enthusiastic and committed individuals. We encourage all to apply. The experience can be extremely fulfilling for all that participate. ODS counselors walk away from camp with fond memories, friendships, evaluations, recommendations, life experiences, and the satisfaction in knowing that they have helped a generation learn about the natural world. Time spent at Outdoor School can also be used towards community service/leadership hours. ďƒŞRead through the materials enclosed in this packet. If you decide you would like the opportunity to participate in this unique program, complete and submit your application to your high school office, the Polk SWCD office, or submit online at the Polk SWCD webpage. The application is due by Tuesday, January 15th, 2013. Complete the application online at You will be notified via email by Tuesday, January 22, 2013 if you have been accepted as an ODS counselor.

APPLICATIONS DUE TUESDAY, JANUARY 15, 2013 For your convenience and ours,

Fill out the application online at Contact us at: Polk Soil & Water Conservation District 580 Main St., Suite A Dallas, OR 97338 Phone: (503) 623-9680 E-Mail: Fax: (503) 623-6335 Web Page: Facebook: Polk SWCD

Eligibility and Requirements o Age: Seniors and juniors preferred, but sophomores are also encouraged to apply. o Grades/Attendance: Minimum GPA of 2.5. Students with less than 2.5 may still apply but must get teachers approval to miss classes. Good attendance is necessary. o Application: Must be completed and submitted by January 15, 2013 to school or Polk SWCD office. o Recommendations: Three (3) must be submitted from non-related adults. Two (2) must be from current teachers. o Homework: It is your responsibility to pre-arrange your absence and complete all homework. o Training: Counselors are required to attend three (3) training sessions to be eligible for ODS o If you have a scheduling conflict, you must contact the Polk SWCD o Arrive on time and be prepared to be there for the full time!

About the Application Process o Application: Complete the packet online (preferred) or by hand and turn into school or Polk SWCD office by January 15, 2013 o Application Questions: Answer the questions in complete sentences to the best of your ability. o Recommendations: You must submit three (3) recommendations. o Recommendations must be from non-related adults you have worked with such as employers, school staff, coaches or other mentors.  Two (2) recommendations must be from High School Teachers.  Teacher references can email the Polk SWCD to receive an online recommendation form  Recommendations are to be placed in a sealed envelope by the reference.  You may also want to stamp and address the envelope to Polk SWCD, 580 Main St., Suite A, Dallas, OR 97338 to ensure your recommendation form will be returned.  Friendly reminders are also helpful.  Verify that the recommendations have been received by the Polk SWCD o Due Date: ODS Counselor Application is due January 15th, 2013 at the School or Polk SWCD office. o Email: You must email from your email. If you do not get a response, check email address and send again. You will be contacted in response to the email you sent. o Selection Committee: Counselors will be chosen by a Polk SWCD Committee with input from school staff, teachers, and counselors. The selection committee will take into account several factors, including the application questions, age, grades, attendance and teacher/staff input. o Acceptance: If you are accepted, you will be notified on January 22, 2013 with a reply to the email you sent us. If you don’t hear from us it is because we did not receive an email from you to reply to. o If accepted, you will be required to complete additional forms. o If you are not accepted, do not take it personally. We want everyone to go to Outdoor School, but sometimes we get far too many applicants and have to make tough decisions. If you have any questions, please contact District Manager Jackie Hastings at (503) 623-9680.

Your Final Check List KEEP THIS PAGE FOR YOUR RECORDS. I completed the application online I have answered the application questions clearly and thoroughly. I have included all three completed adult recommendation forms ________ I have verified all three (3) recommendations were received by the Polk SWCD ________ I have turned in all required documents online or office by January 15th, 2013 or sooner. ________ I have emailed from my email so the Polk SWCD has my correct email address. I have received a verification from them on___________________. I will attend my first training at (circle time) 3:30 to 5:00 OR 6:00-7:30 on Tuesday, February 19th, 2013 at Dallas High School OR Central High School (circle location) __ I will attend my second training at (circle time) 3:30 to 4:30 OR 5:00-6:00 on Tuesday, February 26th, 2013 at Dallas High School OR Central High School (circle location) __ I will attend my third training on Saturday, March 2nd, 2013 from 8:00am – 3:30pm, the Dallas High School Small Gym. I realize ODS is on Wednesday March 13th –Friday March 15th, 2013 at the Oregon 4-H Center.

Important Outdoor School Dates January 15th, 2013: Completed application packet and submitted online. January 22nd, 2013: Accepted counselors will be notified via email – you must have a valid email address! Send an email to to ensure we have your address. Tuesday February 19th, 2013: New Counselor Training (Must attend February 19th, 26th, AND March 2nd, 2013 trainings)  3:30 pm - 5:00 pm, Dallas High School (Little Theatre) or  6:00 pm – 7:30 pm, Central High School (Mr. Neville’s Room) Tuesday February 26th, 2013: All Counselor Training  3:30pm – 4:30pm, Central High School (Mr. Neville’s Room) or  5:00pm – 6:00pm, Dallas High School (Little Theatre) Saturday March 2nd, 2013: All Counselor Training 2  8:00 am – 3:30 pm, at the Dallas High School Small Gym Tuesday March 5th, 2013: Email Check-In with Polk SWCD March 13th-March 15th, 2013: Outdoor School Session!  

Submit this application online by Jan. 15 Accepted counselors will be notified by January 22, 2013 by email

Thank you for applying!

Spread the word! If you know anyone else who may be interested in being an Outdoor School counselor, please spread the word! Let people know we are looking for volunteers!

New Outdoor School Counselor Application This application is due by Tuesday, January 15, 2013. Return to school office or the Polk Soil & Water Conservation District.

Complete the online application at Your Name: School Name: Grade (select):

Last GPA: _________ Current GPA: __________ Sophomore

Date of Birth: _ / _ / 19 __

Junior Senior Sex (select):



Your Address: City/Zip Code: Counselor Cell Phone:

Home Phone:

Email Address:_____________________________________________ PLEASE MARK WHICH TRAINING SESSIONS YOU WILL ATTEND IF ACCEPTED: You must attend all three training sessions! Be prepared to be there the full time!! If you must leave early you will be ineligible to be a Counselor. Training 1: Tuesday, February 19th, 2013 (select one time) _____ 3:30 pm – 5:30 pm, Dallas High School (Little Theatre) _____ 6:00 pm – 8:00 pm, Central High School (Mr. Neville’s Room) Training 2: Tuesday, February 26th, 2013 _____3:30 pm – 4:30pm, Central High School (Mr. Neville’s Room) _____5:00pm – 6:00 pm, Dallas High School (Little Theatre) Training 3: Saturday March 2nd, 2013 8:00 am – 3:30 pm, Dallas High School (Small Gym)

Application Questions (Fill online) Answer these questions using complete sentences to the best of your ability. We are not looking for perfection, but this application is a factor in determining if you will be accepted into the program. There is no right or wrong answers; your answers will help us develop the training sessions. 1. Describe your prior experience working with children:

___________________________________________ 2. Describe your leadership experience. Include any clubs, organizations, or civic groups you are involved in. Have you held any offices in these groups?


3. What are your strengths? How will they help you be an effective counselor?

___________________________________________ 4. Discuss your expectations. What are you looking to gain/learn from this experience?

____________________________________________________ 5. What do you hope the 6th graders will gain/learn by attending Outdoor School?

___________________________________________ 6. Cell phones and MP3 players are not allowed at Outdoor School what are the steps you would take in order to “survive� without them? ___________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________ 7. How would you respond to the following situations? a. One of your 6th graders becomes homesick.

____________________________________________________ b. A child with physical/mental/social disabilities is being made fun of.

____________________________________________________ c. You notice sixth graders at the edge of the pond goofing off; their counselor is not paying attention and does not notice this behavior. ____________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________

8. What are your grades like right now? How will they be affected by missing class for the time you spend at Outdoor School? What is your plan to maintain your grades while you are away?

___________________________________________ 9. Some 6th graders at Outdoor School have disabilities and require patient and accepting counselors. They too deserve the wonderful experience of outdoor learning and are aided by adults from the special needs programs at their schools. Would you be willing to work with special needs 6th graders? Answer this honestly – we are looking for volunteers. ___________________________________ ___________________________________________________________________________________________________________________________

List the Name and Phone Number for Recommendations/References: (attach Recommendations) References MUST be from Non-Related Adults. Two (2) must be from High School Teachers. 1st Reference Name: ___________________________________ Email Address: __________________ 2nd Reference Name: __________________________________ Email Address: __________________ 3rd Reference Name: ___________________________________ Email Address: __________________

Class Schedule: (Type Below)

I acknowledge by including my name and submitting this form, that I am required to complete the following: • Pre-arrange my absence with the school and deal with my homework by completing it or making arrangements to complete it prior to departing Outdoor School (more information at training) • Participate in the three (3) required training sessions.

Remember to email Give the recommendation forms to your references (3 Non-related Adults) in enough time for them to fill them out and turn them back in by January 15th. The recommendation form is included below. Follow-up to ensure they have been submitted.

RECOMMENDATION FOR OUTDOOR SCHOOL COUNSELOR Due January 15, 2013 Applicant Name: Recommended by:


Reference Phone Number: ____________________

Reference Email: _________________________________

Relationship to Applicant: (Must be Non-related Adult)


The student named above is interested in being an Outdoor School counselor responsible for a group of 6th grade students. Listed below are the desired criteria for a student to possess in order to be selected. Your specific assessment will be a confidential one. Please rate this student by circling the number which best reflects him/her for each of the criteria listed. Thank you for your time and effort.

Circle the appropriate number:

Frequently Occasionally Seldom

• Exhibits strong character integrity which sets a positive example for 6th grade students. • Responds to stressful situations in an emotionally mature manner. • Is able to understand the needs of others. • Is able to communicate with others. • Is able to work as a contributing member of a group. • Displays personal initiative. • Exhibits maturity in making decisions. • Seeks assistance when needed. • Is able to talk to someone rather than at them. • Is able to follow directions. • Responds positively to school rules and regulations. • Possesses a sense of humor. • Is able to follow through on a task. • Participates willingly. • Exhibits resourcefulness. • Projects a positive image, which draws respect from others. • Ability to be absent from school. • Ability to accept constructive criticism. Please Circle:








I recommend this student strongly. I recommend this student. I recommend this student with reservation I do not recommend this student

________ ________ __________

Additional Comments: