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:

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