Staff Application

Please select one: —Please choose an option—First Session (5 Weeks)Second Session (2 1/2 Weeks)Full Summer (7 1/2 Weeks)

First Name: Last Name:

Street Address:City: State:ZIP Code:

Email Address:Cell Number: Phone Number:

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

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

What camps have you attended as a camper?

1. Camp: Years There:

2. Camp: Years There:

3. Camp: Years There:

What camps have you attended as a staff member?

1. Camp: Years There: Position:

2. Camp: Years There: Position:

3. Camp: Years There: Position:

List any other work-related experiences:

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)

References:

1. Name:Position:Phone:Email:

2. Name:Position:Phone:Email:

3. Name:Position:Phone:Email:

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

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?

Please upload a recent photo of yourself here: