Staff Application

Please select one: —Please choose an option—Session one 4 weeksSession two 3 weeksFull summer 7 weeks

First Name: Last Name:

Street Address: City: State: ZIP Code:

Email Address: Cell Number: Phone Number:

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Birthdate (mm/dd/yyyy): Current Grade: 101112Post HS Current Age:

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High School: Years Attended:

Bais Medresh: Years Attended:

College: Years Attended:

If attending college, will your college / exam schedule interfere with the camp schedule? —Please choose an option—YesNo

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What camps have you attended as a camper?

1. Camp: Years There:
2. Camp: Years There:
3. Camp: Years There:

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What camps have you attended as a staff member?

1. Camp: Years There: Position:
2. Camp: Years There: Position:
3. Camp: Years There: Position:

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List any other work-related experiences:

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What type of position are you applying for? (List in order of preference)

If applying as counselor, what age group would you prefer? (We can not guarantee any age group)

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References:

1. Name: Position: Phone: Email:
2. Name: Position: Phone: Email:
3. Name: Position: Phone: Email:

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If you are only applying for one month, what are your plans for the other month? (If applying for full summer, write n/a)

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Do you hold a current lifeguarding certificate? If yes, please describe. Do you play a musical instrument? If yes, please describe. Do you have any other special talents? If yes, please describe. What do you think a counselor's job in camp should be? Why did you choose to apply to Camp Dora Golding?

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Please upload a recent photo of yourself here: