MAX Day Camp Application

Form
MAX Day Camp Counselor

Application 2026
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender
Current School
Graduation Year
Proposed Major
What are your career interests?
Permanent Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Disclosure of Misconduct: Have you ever been convicted of, or is any charge now pending or expected to be brought against you for any crime other than a minor traffic violation?*

NoYes
Have you ever, at any academic institution been in other than good standing because of academic deficiencies, been censured for misconduct, or been the subject of disciplinary proceedings?*

NoYes
Languages Spoken
Special Skills/Talents
1. Why do you want to be a Day Camp Counselor? What contributions would you bring to our staff? What do you hope to learn?
2. List and describe three important qualities of an outstanding educator.
3. Describe your plan for classroom management.
4. Tell us a story from your middle school years. How does this experience impact your expectations of your students and yourself?
5. Identify some creative (out of the box) activities you would consider using in the classroom (including the use of technology) and why you might consider using those activities or technologies.
6. List any experiences you have had working with children.
7. List any positions of leadership you have held.
References: Please provide us with three professional references including name, title, address and phone number.
Resume (if applicable)

Cancelof
Clearance Forms: If you have any current (dated within one year) clearances, please provide us with a copy (do not send originals)

Cancelof
Transcripts: Please provide us with the most recent copy of your unofficial transcripts.

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Should be Empty:

Form

MAX Day Camp Counselor