Summer Camp Counselor Application 2022

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UPAC has a long term vision to heal communities by breaking the cycle of youth violence from the ground up. Through partnerships with law enforcement, educators, local businesses, community leaders, local government, and volunteers we are able to do this.

Summer Camp - Our summer camp allows inner city youth an opportunity to explore nature, build everlasting relationships, have outdoor experience and so much more. We depend on our volunteers to serve as counselors at our annual summer camp.

Email *

Last Name: *

First Name: *

Middle Name:

Street Address: *

City and State: *

Zipcode *

Cell Phone: *

Secondary Number: *

Email Address: *

Age: *

Date of Birth: *

YYYY

Have you ever been convicted of a criminal offense? *

Yes

Other:

If yes to the conviction question, please explain:

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