Camp Shoresh Staff Application 2019
Please fill out the following application by answering all questions accurately and honestly.
First Name *
Your answer
Last Name *
Your answer
Social Security Number *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Cell Phone Number *
Write NONE if applicable
Your answer
Email Address *
Your answer
Age *
Your answer
Date of Birth *
List as Month/Day/Year
Your answer
Current Grade
Your answer
T-Shirt Size *
Choose One
Education
List the Yeshivos/Schools attended since the start of High School
School #1 *
Please include City and State
Your answer
School Phone Number
Your answer
Year(s) Attended *
Your answer
Grade(s) *
Your answer
Degrees
Your answer
School #2
Please include City and State
Your answer
School #2 Phone Number
Your answer
Year(s) Attended
Your answer
Grade(s) Attended
Your answer
Degree
Your answer
School #3
Please include City and State
Your answer
School #3 Phone Number
Your answer
Year(s) Attended
Your answer
Grade(s)
Your answer
Degree
Your answer
Camping Background
List all camps in which you have been employed
Camp
Your answer
Year(s)
Your answer
Camp Reference
Your answer
Phone Number
Your answer
Position and Age Group
Your answer
Salary
Your answer
Camp
Your answer
Year(s)
Your answer
Camp Reference
Your answer
Phone Number
Your answer
Position and Age Group
Your answer
Salary
Your answer
Work Experience
Name of Employer
Your answer
Position
Your answer
Address
Include City and State
Your answer
Supervisor
Your answer
Supervisor Phone Number
Your answer
Employer 2
Your answer
Position 2
Your answer
Address
Include City and State
Your answer
Supervisor
Your answer
Supervisor Phone Number
Your answer
Character References
Please list 3
No Relatives please
Character References *
Please include Name, Address, Telephone Number and Relationship
Your answer
Camp Program Skills
Please put a "T" after those activities you can teach as an expert, an "A" for those activities you can assist with, and a "C" after those in which you have current certification.
Adventure/Nature
Challenge/Ropes Course
Your answer
environmental studies
Your answer
Gardening
Your answer
Insects
Your answer
Arts/Crafts
Crafts
Your answer
Drawing/Painting
Your answer
Photography
Your answer
Woodworking
Your answer
Campcraft
Bonfire Making
Your answer
Hiking
Your answer
Wilderness Skills
Your answer
Dance/Fitness
Aerobics
Your answer
Hip-Hop Dancing
Your answer
Gymnastics
Your answer
Israeli Dance
Your answer
Drama
Theatre
Your answer
Music
Singing
Your answer
Instrument
please list
Your answer
Sports
Archery
Your answer
Baseball/Softball
Your answer
Basketball
Your answer
Fishing
Your answer
Football
Your answer
Gym Hockey
Your answer
Martial Arts
Your answer
Skating
Your answer
Soccer
Your answer
Volleyball
Your answer
Waterfront (Staff members who are certified to teach swim lessons will be paid more)
Canoeing
Your answer
Kayaking
Your answer
Rowing
Your answer
Swimming (Staff members who are certified to teach swim lessons will be paid more)
Your answer
Miscellaneous
Foreign Language
please list
Your answer
Laining
Your answer
Storytelling
Your answer
Other
Your answer
Certifications/Experience
Do you carry current certificates in First Aid? CPR? Lifeguarding?
How would you describe your swimming ability?
Your answer
List any other certificates, degrees, accreditations, etc that might be helpful in camp.
Your answer
List any other previous jobs or experiences that you feel would be an asset as a counselor
Your answer
Self Assesment
What talents or abilities do you feel would be your strengths in working in our camp?
Your answer
Do you have any youth leadership experience?
Your answer
What areas or responsibilities do you feel would be challenging or difficult for you in our camp?
Your answer
What age group do you want to work with in camp? Why? *
ex. Little/Junior Shoresh, Lower Division, Upper Division, CITs
Your answer
Can you drive a van?
I authorize investigation of all statements herein, including any checks of criminal records, and release the camp and all others from liability in connection with same. I understand that, if employed, I will be an at-will employee unless there is an agreement or law that alters that status. Furthermore, I understand that any agreement must be in writing and signed by the Camp Shoresh Director. I also understand that untrue, misleading, or omitted information herein or in other documents completed by myself may result in dismissal, regardless of the time of discovery by the camp. *
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