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Senior Staff Application 2011
Thank you for your interest in serving as a Senior Staff member for Iowa HOBY. Please complete this online application by April 1, 2011 for best consideration. All applicants will be notified of their status prior to May 13th. The Iowa HOBY Leadership Seminar will be held June 10-12, 2011 at Central College in Pella, Iowa. All Staff Training would begin by 6pm on June 9th, 2011.

Questions? Contact Lesley Anderson, Director of Senior Staff.

CONTACT INFORMATION
Last Name First Name Middle Initial

Home Phone Cell Phone

Street Address City State Zip

Email Date of Birth

Best Method of Contact If Phone, Best Time to Call

LEGAL INFORMATION
Have you ever plead guilty, "no contest," been found guilty, or been convicted of (a) any felony or (b) any misdemeanor involving violence, sexual misconduct, or posession, transport, or sale of illegal drugs? Note: Existence of convictions will not necessarily disqualify any application from participation. If a guilty plea of conviction has been expunged from your criminal record, you do not have to disclose and may answer "No."
If you answered, "Yes," please explain in the space below giving the date, location, and charge.

Iowa HOBY conducts criminal background checks to ensure the safety of our participants, volunteers, and support staff. Do you give Iowa HOBY permission to conduct a background check on your criminal history?

QUESTIONS
Have you been involved with Iowa HOBY, HOBY International, or any other state affiliates of HOBY in the past? If yes, please list your title(s), date(s), and location(s) of your previous participation with HOBY. If no, how did you hear about us and why do you want to participate in this year's seminar?


Do you have any prior experience working with high school aged individuals? If yes, please explain.

Are you able to be at Central College in Pella on Thursday, June 9, 2011 at 7:00 p.m. for Senior Staff Training?
Would you like to be put on a "carpool" list that would be available for staff only?
Would you be willing to have a roommate during the HOBY Seminar? (If no, you will be granted a single room. If yes, all non married Senior Staff may submit same sex roommate requests to Shana Smrcina at shana.smrcina@gmail.com.)
Would you like to be involved with the planning team of the seminar?

Do you have suggestions for other people who should be considered for the Senior Staff? If yes, please list the name and contact information of the individual(s) below.

RETURNING SENIOR STAFF
What suggestions do you have for this year's seminar? This is an open forum, so please feel free to speak candidly. We are always looking for ways to improve the seminar each year and want to make everyone's experience a positive one!