PERSONAL INFORMATION
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| * First Name: |
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| * Last Name: |
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| * Date of Birth: |
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| * Gender: |
M F |
| * Email: |
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| * Home Address: |
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| * City: |
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| * State: |
Country:
* Zip:
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| * Home Phone: |
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| Are you currently a student? |
Yes No |
| If no, Current Occupation: |
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If yes, please provide school information below.
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SCHOOL INFORMATION
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| Name of School |
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| Current Year |
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| Address at School: |
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| City: |
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| State: |
Country:
Zip: |
| Phone at School: |
Cell Phone:
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EDUCATION HISTORY
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GENERAL INFORMATION
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| * How did you hear about us?
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Do you Smoke?
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Do you consume alcoholic beverages?
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Do you have body piercings?
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Do you have any tattoos?
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| Salary Expectations
Available Dates? |
* Staff should be available from June 14th through August 16th
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| Have you worked at a camp before?
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If Yes, please provide the name of camp, the director and phone number,
the dates you worked and in what capacity:
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OTHER PAST EMPLOYMENT
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Hobbies/Organizations/Clubs (include any leadership positions held):
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* I am applying for a job in the following area(s):
Counselor
Office
Medical
Support
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APPLYING FOR COUNSELOR POSITION
The following is for those applying as a COUNSELOR ONLY. For office, medical and support positions please skip to the next section.
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Please put 1 before the following activities you can organize and teach as an expert, 2 for those activities you can assist in teaching,
and 3 for those in which you have had some useful experience. Leave the area blank if you have very little or no experience.
1 = ability to organize & teach
2 = ability to assist in teaching
3 = possess some useful experience
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Swimming
Kayaking
Waterskiing
Kneeboarding
Jr. Lifesaving
Sailing
Wakeboarding
Rowing
Canoeing
Windsurfing
Boat Driving
Fishing
Archery
Riflery
High Ropes
Low Ropes
Zip Line
Giant Swing
Climbing
Outdoor Living Skills
Outdoor Cooking
Overnight Trip Leading
Animal Care
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English Horseback Riding
Western Horseback Riding
Tennis
Golf
Basketball
Lacrosse
Flag Football
Australian Rules Football
Soccer
Baseball
Volleyball
Field Hockey
Softball
Wrestling
Karate
Martial Arts
Dance
Ballet
Hip Hop
Inline Skating
Roller Hockey
Cheerleading
Pom Poms
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Yoga
Gymnastics
Aerobics
Pilates
Arts and Crafts
Set Design
Jewelry Making
Ceramics
Fine Arts
Hebrew Tutoring
Cartooning
Model Rocketry
Chess
Guitar
Computers
Newspaper
Web Design
Photography
Drama/Theater
Comedy
Digital Photography
Videography
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In the boxes below, elaborate on your top 3 ACTIVITY skills from the list
above that you are capable of teaching at camp. Please detail any personal or teaching experience you have in connection
with these skills.
Skill 1
Skill 2
Skill 3
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APPLYING FOR OFFICE, MEDICAL OR SUPPORT POSITIONS
For counselor positions please see above section
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For office, medical or support positions, please check all you are applying for:
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In the boxes below, please elaborate on your skills and experience that qualifies
you to hold one of these jobs.
Ist Job Choice
2nd Job Choice
3rd Job Choice
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ADDITIONAL INFORMATION AND REFERENCES
For ALL Applicants
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What experiences do you have interacting with
children that you haven't already told us?
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What attributes do you posses that would make you a
valuable staff member of our camp?
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List all current or expired certifications you hold. (i.e. first aid,
CPR, life guard, WSI, LGI, RN, Ropes etc.) and expiration dates.
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REFERENCES
Please provide 3 professional references, please do not include co-workers:
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