Summer Blast & Camp Galena 2021 Counselor Application
Please fill out the application below to apply to be a counselor.
**APPLICATION DEADLINE: January 20, 2021**
SUMMER BLAST DATES (for campers grades 1-5): June 14-17, 2021
CAMP GALENA DATES (for campers grade 6-8 and CIT'S grade 9): July 10- 17, 2021
Any questions?? Contact Katie at
katiehinderer@gmail.com
* Required
Email address
*
Your email
Your Last Name
*
Your answer
Your First Name
*
Your answer
Counselor Name (if you have previously been a counselor)
Your answer
Date of Birth
*
Your answer
Home Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Your Cell Phone
Your answer
Your School
*
Your answer
Year you will be entering in Fall 2021
*
Sophomore
Junior
Senior
Freshman in College
Other:
How did you hear about camp?
*
Your answer
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