Staff Application 2024
Position applying for (1st Choice)
*
Please Select
Counselor
Junior Counselor
Rotator
Waiter
Maintenance
Lifeguard
Other
(2nd Choice)
Please Select
Counselor
Junior Counselor
Rotator
Waiter
Maintenance
Lifeguard
Other
Other Position:
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Number
Please enter a valid phone number.
Applicant Cell #
Please enter a valid phone number.
Applicant Email
example@example.com
Age
Date of Birth
*
/
Month
/
Day
Year
Date
Is applicant fully immunized? Applicants not immunized will not be accepted.
Yes
No
If yes, are supporting documents available?
Yeshiva Currently Attending
Phone number where applicant can be reached
Yeshiva Address
Rebbe's Name
Rebbe Phone #
Grade
Please Select
12
1st Year BM
2nd Year BM
3rd Year BM
4th Year BM
Other
Does the applicant have food allergies?
Yes
No
Explain Allergies
Father's Name
Father Cell#
Mother's Name
Mother Cell#
Parent's Email Address
Emergency Contact Name and Number
General Comments (Previous Camps, Talents etc.)
Signature
*
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Should be Empty: