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Counselor Application

Counselor Application

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Apply Now for An Experience of A Lifetime!

To Apply for a counselor position in Camp Gan Israel of Rochester please fill out the following form:

Staff Information
Name
First
Middle Last
Address
Street
City State
Zip
Date of Birth
Age:
Contact Info
Phone
Email

Education:

School:
Grade: City:

Camp Attended Last Year:

Camp:

Head Counselor:
Year:
Phone:
Position:

E-mail:
Previous Camp Experience
Camp:

Head Counselor:
Year:
Phone:
Position:

E-mail:
Reference:
Name
Phone Relationship/Title
School Reference:
Name
Phone Title
Questions:
Special talents, interests, hobbies:

What age children do you like working with?
Do you drive? Yes No if yes for how long?

Are you certified in first aid? Yes No
Are you a certified Life Guard? Yes No
Do you have medical insurance in NY State? Yes No
Do you have any food restrictions? Yes No Please specify
Please list any extra Hidurim in Kashrus (other then pas & cholov yisroel):
Have you applied to any other camp? Yes No
Do you agree to abide by all the camp rules (including the highest level of Tznius)? Yes No
Do your have permission from your parents to apply for this camp? Yes No

Do you watch movies ? sometimes never

Do you read secular books? occassionaly never

Do you try to say chitas usually? occasionally most of the time

Please email a recent picture to chany@cgirochester.com with your name in the subject.

Comments:
Please note anything that you feel we should know in considering this application:
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