APPLICATION for Summer 2026 Camps

APPLICATION for Eagle-Orzeł Educational and Cultural Exchange, Inc. Summer 2026 Camps

For ALL APPLICANTS (New or Returning)
1. I am applying to be a
2. I am applying to be a volunteer at the camp in :
3. Name (as it appears on passport)

First NameMiddle NameLast Name
4. Permanent Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
5. Primary Phone Number

Area CodePhone Number
6. Primary Email
example@example.com
7. Date of Birth

MonthDayYear
Date
8. United States Passport Number - Applicants must be citizens of the United States and possess a valid passport with an expiration date not less that 3 months upon returning to the United States.
If you do not have a passport, please write, 'currently applying'.
9. Passport Valid Until

MonthDayYear
Date
10. Name of Emergency Contact

First NameLast Name
11. Emergency Contact Relationship
12. Emergency Contact Phone Number

Area CodePhone Number
13. Emergency Contact Email
example@example.com
14. Emergency Contact Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
15. Educational Background
Please indicate earned degree(s) with completion date and name of institution. If currently in college, indicate major/minor and institution attending. If not attending college, please list the last institution attended.
16. Professional Teaching Experience
Please list teaching experience beginning with current position.
17. Other Professional/Work Experience (Including volunteer service)
Place of Employment/Organization/Location/Position/Dates
18. Please list other experiences, travel, and activities which you consider relevant to teaching English, leadership topics, and/or the arts outside the United States.
19. List suggestions for extracurricular activities you would be able to organize and lead at the camp.
20. List honors, publications, and achievements.
21. List memberships/participation/leadership in educational, cultural, extracurricular, civic and other organizations.
22. Why do you want to participate in this program?
23. How did you hear about this program?
24. Do you have Polish heritage? NOTE: Polish ancestry is NOT required for participation in this program.
25. What qualifications and traits do you have that especially qualify you for participation in this program?
26. Lesson Plan For Teacher Applicants:

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Please develop and submit a sample lesson plan that you might use in this program. Cancelof
27. Have you ever been disciplined or charged for insubordination, incompetence or inappropriate conduct while employed?
28. Have you ever been charged with a felony or misdemeanor?
29. Have you ever been arrested or convicted of a crime?
30. If you responded "yes" to Questions 27, 28, or 29, please explain.
31. Please upload a head shot photo of yourself.

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32. Required Physician's Certificate

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Please upload the signed and stamped certificate found on our website. Only this certificate is acceptable. Please make sure that you also sign the certificate. Cancelof
33. Copy of Teaching Certification

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For teachers only. Cancelof
34. Do you have a current and valid background check (such as one required for a teaching position or other employment)?
35. Please upload your current curriculum vitae or resume.

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Recommendations

36. Please provide the name and e-mail addresses of two individuals that you have contacted to serve as professional references for you (excluding family members and friends). Recommenders should complete the recommendation form available here by January 18, 2026 https://form.jotform.com/252308058267156. Kindly share this link with your recommenders. The selection committee takes the reference forms very seriously. If your reference forms are not received by January 18, 2026, your application will be INCOMPLETE and will not be considered.
Name of Recommender 1

First NameLast Name
Email for Recommender 1
example@example.com
Name of Recommender 2

First NameLast Name
Email for Recommender 2
example@example.com
37. Please verify that you are human.
38. Agreement. By checking the box below, I hereby attest that all information provided in this application is true and that I assume responsibility for my responses. I authorize the Eagle-Orzel selection committee to process, review, and discuss my application materials.
39. By checking the box below, I understand that if I am selected for and agree to participate in the program, I will pay the required, nonrefundable fee of $250 by the date outlined in the registration and acceptance form.
40. Signature
41. Today's Date

MonthDayYear
Should be Empty:

APPLICATION for Eagle-Orzeł Educational and Cultural Exchange, Inc. Summer 2026 Camps

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