Please select one: —Please choose an option—Session one 4 weeksSession two 3 weeksFull summer 7 weeksFirst 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—YesNoWhat camps have you attended as a camper?Camp: Years There: Camp: Years There: Camp: Years There: What camps have you attended as a staff member?Camp: Years There: Position: Camp: Years There: Position: 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 cannot guarantee any age group.References:Name: Position: Phone: Email: Name: Position: Phone: Email: 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:
