NESA Summer Camp application form
Email *
Name *
First and last name
Email *
Phone number *
Home Address *
Date of Birth *
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Social Security # (Qualified lead counselor candidates will require a background check) *
List Extracurricular Activities/ Honors/ Hobbies *
Educational Background (list high school, college/major, dates, degrees) *
Work Experience (please include contact info) *
May we contact the employers listed above for work references? *
Summer camp work involves close contact with children. Have you ever been investigated, arrested or convicted of Child Abuse, Neglect or Related Charges? *
Have you ever been investigated, arrested or convicted of Drug or Alcohol charges? *
Have you ever been convicted of any other criminal activity? *
If yes, please explain.
Camp work requires physically demanding activity including lifting and carrying. Do you have any physical limitations that would prevent you from performing the work for which you are being considered? *
If yes, please explain.
List any camp-related or other relevant activities in which you have a moderate or high degree of expertise and tell where/how you developed this experience. *
List camp-related certifications you currently hold. *
List 3 personal references (individuals not related to you who you have known for at least 1 year. Please give names/emails/phone #s) *
Which position(s) are you interested in (applicants under 18 years old cannot be considered for a lead counselor position)? *
Required
Why do you want to be a camp counselor at NESA? *
What weeks of camp are you interested in being a counselor for? *
Required
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