Family Service of Lake County Nuestro Verano Volunteer Camp Counselor Application
Nuestro Verano Summer Camp runs Mondays through Thursdays from 12:30pm-4:00pm at Oak Terrace Elementary School (240 Prairie Ave., Highwood) starting June 17th through July 18th. Campers will be incoming 1st through 5th graders. Volunteers will be needed from 12:00pm - 4:30pm. Volunteer participation is highly encouraged for the entire 5 weeks of the camp. A commitment of 2-4 days per week is required in order to volunteer. Field trips will be scheduled on some camp days and the time of departure and arrival will vary.

***MANDATORY SUMMER CAMP COUNSELOR TRAINING***
ONLY returning volunteers that have been trained within a year will be exempt from the training

NUESTRO VERANO POLICIES AND PROCEDURES & FIRST AID TRAINING
Tuesday, June 11 OR Wednesday, June 12
Both sessions are from 4:00pm-6:30pm
Nuestro Center (501 Bank Lane, Highwood, IL 60040)

General Information
Name: *
Your answer
Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip Code: *
Your answer
Phone #: *
Your answer
E-mail: *
Your answer
Age: *
Your answer
Date of Birth: *
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If you are under 18, please fill out:
Name of Parent or Legal Guardian:
Your answer
Address:
Phone #:
Your answer
Emergency Contact: *
In case of an emergency, please notify:
Phone #: *
Your answer
Relationship: *
Your answer
Are you a current student? *
Grade: *
Grade in School for Fall 2019
School Name: *
List all allergies/medical conditions you have: *
Other Information
Adult T-Shirt Size: (ONLY for Thursday volunteers)
Special Skills
Please list any special talents you may want to share with the children: *
Your answer
Spoken Langauges: *
Required
Preferred child age group to work with: *
Required
Experience
List your past volunteer experience: *
Your answer
What experience do you have working with youth?: *
Your answer
Interest
How did you hear about Family Service of Lake County/Nuestro Center?: *
Required
Why are you interested in volunteering at Family Service of Lake County/Nuestro Center?: *
Your answer
Would you like to receive informational/program emails about Nuestro Center and Family Service of Lake County?: *
Ex: other volunteer opportunities, special events, newsletters.
Availability
Please let us know what days you will volunteer:
What day(s) of the week you available to volunteer? : *
Required
Please list any known absent dates during which you will not be able to participate as a volunteer at Nuestro Verano: *
Your answer
What volunteer training date will you be attending?: *
**Volunteers are required to attend a training prior to their 1st volunteer day. Training will be held at Nuestro Center (501 Bank Lane, Highwood, IL 60040). ONLY returning volunteers that have not been trained within a year will be exempt from the training.
Please list two references that are not related to you (teachers, employers, adult friends)
**Please have them fill out a recommendation form (see below).
Reference Name 1:
Your answer
Phone:
Your answer
Relationship:
Your answer
Recommendation Form 1
**Please print and return form to Nuestro Center.
Reference Name 2:
Your answer
Phone:
Your answer
Relationship:
Your answer
Recommendation Form 2
**Please print and return form to Nuestro Center.
Criminal Background Check
**If you are 18 years of age or older, please also complete and return the State of Illinois’ Authorization for Background Check (attached).
Have you ever been convicted of a felony? : *
If yes, please explain:
Your answer
DCFS Authorization for Background Check
**If you are 18 years of age or older, please complete and return the State of Illinois’ Authorization for Background Check form to Nuestro Center.
Photo Release Form
**Please print, sign and return form to Nuestro Center.
Liability Form
**Please print, sign and return form to Nuestro Center.
Signature *
I understand that this is an application for a volunteer opportunity. Acceptance is based on all application documents received and requirements met. I certify that this information is true, correct and complete to the best of my knowledge.
Your answer
Date *
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