B”H
Camp Counselor Application

Name:
Date of Birth:
Age:
Address:
Cell Number:
E-mail Address:
Parent’s Name:
Parent’s Address: (if different)
Parent’s Phone Number:
Father Cell:
Mother Cell:
Parents E-mail Address:
School Attending:
Grade:
Names and Phone Numbers of references at school:
Names of past camps that you worked at:

Past camp experience:

Names and Phone Numbers of references from past camps:

Any Specialties:

Please describe your goals as a counselor
Do you have your license?
If yes for how long?
Do you lifeguard?
Medical Insurance Information

(our camp does not provide our staff with medical insurance)