Counselor Employment Application, Camp Kooka-Racha 2026

DEMOGRAPHIC INFORMATION
Full Name*

First NameLast Name
Birth Date*

MonthDayYear
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Email Address*
example@example.com
Your Phone Number*
EMERGENCY CONTACT INFORMATION
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship *
REFERENCE

This can be a former employer, teacher, or mentor who can speak to your character and work ethic.
Reference Name*
First and Last
Reference Phone Number
Please enter a valid phone number.
Reference Email
example@example.com

Please answer the following questions so we can get to know you better!
Have you worked at Camp Kooka-Racha before? *
If so, what year(s)?
Have you ever been a CIT (counselor in training) before?*
If so, where were you a CIT in the past?
Have you worked in child care before? If so, please explain.*
Recall a time when you managed a difficult behavior. Explain the behavior and how you responded. *
Counselors are asked to lead a group of campers and help them complete one (1) final project by the Friday of the camp session (Example of a project: making a compass with water, a pin, and a magnet). Are you comfortable leading hands-on activities like this? *
If provided the end goal are you able to prepare daily lesson plans, and gather the necessary materials? *
How would you bring positivity and morale to camp? *
Which sessions are you available for?

Session 1: June is 8 - 12 (The Perfect Storm)Session 2: June 11 - 19 (Nature Unleashed)Session 3: June 22 - 26 (Time Travelers)Session 4: July 6 - 10 (Shark Week)Session 5: July 13 - 17 (Flight Force)Session 6: July 21 - 25 (Color Lab)

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Position #1
Please list your previous work experience as Job title, company, how long you worked there, and main responsibilities.
Position #2
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Position #3
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Camp Kooka-Racha Counselor