Junior Counselor Application
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Information
Parent 1 Name
*
First Name
Last Name
Parent 1 Email
*
example@example.com
Parent 1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent 2 Name
First Name
Last Name
Parent 2 Email
example@example.com
Parent 2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Essay Questions and Recommendations
Are you currently a member of the Mt. Sterling YMCA?
*
Yes
No
What days of the week would you be available this summer (June - August)?
Monday
Wednesday
Friday
How many days would you prefer to serve as junior counselor this summer?
1 day a week
2 days a week
3 days a week
Why do you want to be a junior counselor at the Mt. Sterling YMCA?
*
How do you live out our core values of honesty, respect, responsiblity, and caring?
*
Application requires TWO letters of recommendation from a teacher, coach, and/or school administrator. Please upload or email to ymcamcarmean@casscomm.com. Applications without letters will NOT be accepted.
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