Camp Jack Jr. Counselor Application

Camp Jack Jr. Counselor Application
Thank you for your interest to serve at Camp Jack!

Application Process
1. Commit to serving a weeklong commitment from June 21-27, 2025
2. Complete and submit the Camp Jack Jr. Application
3. Meet with Laurie Mikolaycik, Camp Jack Director
4. Complete and submit the Camp Jack Jr. Permission Form
This application is for volunteers under the age of 18. If you will be age 18 by June 21, 2025, please complete the Camp Jack Paid Counselor Application.
Jr. Counselor Information
Are you under age 18?*

YesNo
Counselor Name*

First NameLast Name
Counselor Email
example@example.com
Counselor Phone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth:*

MonthDayYear
Date
T-shirt Size:*
Gender:*
School Name* Grade*
Is this your first time serving as a Jr. Counselor?*

YesNo
Please share how being a Camp Jack Jr. Counselor would be a ministry opportunity to be a servant leader - rather than just a summer activity?*

Jr. Counselor Information