Counselor Application for Anshei Lubavitch Day Camp
Counselor Application for Anshei Lubavitch Day Camp
Email address *
Last Name *
Your answer
First Name *
Your answer
Date of Birth *
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How old will you be this July? *
Your answer
Address *
Your answer
Home Phone *
Your answer
Cellphone Number
Your answer
Mothers Email Address *
Your answer
Mother's Cellphone *
Your answer
Mother's Work Number *
Your answer
Father's Cellphone *
Your answer
Father's Work Number *
Your answer
What school do you currently attend? *
Your answer
What grade are you currently in? *
Your answer
What shul is your family affiliated with? *
Your answer
Which camps have you attended? *
Your answer
Which camps have you worked for , if any?
Your answer
Which Position are you applying for? *
Are you applying for a volunteer position or a paid position? *
Your answer
Which age children do you prefer to work with? *
Why?
Your answer
Do you have experience working with children? If yes, give full details. Please include if it was a volunteer or paid position. *
Your answer
Other work experience
Your answer
Do you have any special talents you would like to share in camp? (gymnastics, dance, drama/ acting, cake decorating, etc)
Your answer
Are you a certified lifeguard? *
Your answer
Please provide a reference (not related to you) *
Your answer
In what capacity does this reference know you? *
Your answer
Phone number for your reference? *
Your answer
Email for your reference? *
Your answer
Please provide a second reference (not related to you) *
Your answer
In what capacity does this reference know you? *
Your answer
Phone number for this reference? *
Your answer
Email for this reference *
Your answer
Do you have any illnesses? If yes, explain *
Your answer
Do you have any mental health issues? If yes, explain *
Your answer
Do you take any medication? if yes, please explain *
Your answer
Do you have any allergies? if yes, please explain *
Your answer
Which session(s) are you interested in working? *
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