Employment Application Form

Pre-Screen Interview Application

Please fill the form below accurately indicating your potentials and suitability to the job you are applying for.
Name*

First NameLast Name
Birth Date

MonthDayYear
Best Phone Number to Reach You (Phone Call/Text)*
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Staff Locations: Please choose the areas you would feel comfortable driving to in order to work for us this summer.

Metrowest Massachusetts (areas close to/near Newton, Westwood, West Roxbury)MetroNorth Massachusets (areas close to/near Wakefield, Burlington, Medford, Melrose)Southern New Hampshire (areas close to/near Windham, Salem, Manchester)Central New Hampshire (areas close to/near New London, Concord)Seacoast New Hampshire (areas close to/near Portsmouth, Durham, Dover)Vermont
Staff Position: Please choose what position you may be qualified for based on your age and experience:

Program Director (21+)Assistant Director (18+)Lead Teacher (18+)Junior Counselor (16+)CIT (Counselor in Training) (14+)
Mandatory Trainings: I understand and agree to the above mandatory trainings (should I be hired)

Thursday, May 29, 2025 6:30pm-8pm Virtual Training via ZoomSaturday, May 31, 2025 Training in Salem, NH (For NH staff)Saturday, June 7, 2025 Training in Brookline/Newton, MA (For MA Staff)Tuesday, June 10, 2025 4pm-8pm Vermont Staff Training
Work availability: How many hours are you willing to work per week?

0-1010-1515-2525-35
Which weeks can you work? (Check all that apply)

June 16-20June 23-27June 30-July 3July 7-11July 14-18July 21-25July 28-Aug 1August 4-8August 11-15
How were you referred to us?*

Walk-InReferralNewspaper AdFacebookTwitterLinkedInOther (please specify)
If you had a referral, please name your referral below:
What is your comfort level with technology? (Use of ipads, laptops, projectors, etc.)

I feel very comfortable and use it in my every day life.I feel somewhat comfortable and use it sometimes in my every day life.I feel not so comfortable and technology makes me uneasy.I feel absolutely uncomfortable with technology.
I understand there will be a background check completed.

Yes, I understand.No, I don't understand.
I understand I must have a license or reliable transportation for this position.

Yes, I understandNo, I don't understand
Have you worked in a summer camp or school setting before? (Check all that apply?

Summer campSchool settingThis would be my first experience.
What age group do you prefer working with? (Check all that apply)

4-5 year olds6-8 year olds9-13 year oldsI don't like working with children
Resume and Files

Cancelof
Motivation letter: It is extremely important that we maintain a high level of professionalism when it comes to staff work ethics, attention to detail, safety and responsibility to the children in our program. What characteristics do you possess that make you qualified to be in our program and trusted with the well-being of our children and overall STEM program? What makes you want to work for LetGoYourMind?*
Is there any other additional information that you would like to share with us? Are there any qualities you possess that were not address in this application that you feel that are important to share?
By typing your name in the box below, you certify that all of the information that you have provided on this application is true and correct.

Powered by Jotform SignClear
Should be Empty:

Pre-Screen Interview Application