Eugene Science Center Camp Counselor Application
Summer Camp Counselors are committed for at least one full week of camp. Prior ESC volunteers still need to fill out this form to be camp counselors. All counselors must attend a camp counselor training.
Full Name *
Your answer
Today's Date
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Mailing Address *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Name and phone number of your Emergency Contact: *
Your answer
Please let us know about any skills, talents, or topics you are knowledgeable about (ex. arts & crafts, sports, group games, science topics, etc):
Your answer
Are you comfortable leading 20 minute activities for k-5th grade students within your listed skills/knowledge?
Which weeks are you available for camp? *
Morning Shifts (8:00am to 12:30pm)
Afternoon Shifts (12:30pm to 5:00pm)
Full Day Shifts (8:00am to 5:00pm)
Not Available this Week
Week 1: June 25 - 29
Week 2: July 2 - 6
Week 3: July 9 - 13
Week 4: July 16 - 20
Week 5: July 23 - 27
Week 6: July 30 - Aug 3
Week 7: Aug 6 - 10
Week 8: Aug 13 - 17
Week 9: Aug 20 - 24
Week 10: Aug 27 - 31
Are you currently in school during the school year? *
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