2026 Seasonal Employment Application - Summer Playground
Please complete this application to be consider for a position with the Pottsgrove Recreation Summer Playground Program. 2026 Summer Playground runs June 15-July 16 Monday-Thursday at Lower Pottsgrove Elementary School. Playground Days are from 8:45-12:15 for staff. Field Trip Days vary and could start as early as 8am and go as late as 2pm but will be scheduled ahead of time.
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
-
Month
-
Day
Year
Please provide if under 18.
Social Security Number
Email
example@example.com
Position(s) applying for
Leader - 18+, 2 years experience
Sr. Counselor -18+, 1 year experience
Counselor - 16+
Jr. Counselor - 15+, 1 summer experience
Counselor in Training - 14+, no experience (Volunteer Position)
Weeks Available to Work:
June 15 - 18, 2026
June 22 - 25, 2026
June 29 - July 2, 2026
July 6 - 9, 2026
July 13 - 16, 2026
Please explain any weeks/days you will not be available.
Please indicate t-shirt size
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Education Information
High School
Current Year/Graduation Year
High School City/State
College/University
Current Year/Graduation Year
College/University City/State
Concentration/Major
Post Graduate Education
Current Year/ Graduation Year
Concentration/Major
Skills & Training
Please list all applicable skills and training for applicable job. (babysitting, community service, school clubs, sports, computer skills, etc.
Employment
Company Name
Position
Supervisor's Name
Supervisor's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Dates
Duties Performed
Company Name
Position
Supervisor's Name
Supervisor's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Dates
Duties Performed
References
Reference Name
Reference Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship
Company/School
Reference Name
Reference Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship
Company/School
Emergency Contact
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship
Allergies or Important Medical Information
Please provide any information you feel we need to know to help in the event of an emergency.
Save
Submit
Should be Empty: