Camp Ashira | Staff Application

Camp Ashira | Staff Application
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone*

Area CodePhone Number
Cell Phone Number*

Area CodePhone Number
E-mail*
Birth Date*

MonthDayYear
Current Age*
Current Grade*
School Presently Attending*
Age Group Preferred
List Previous Experience With Children*
List any special talents you have that can be an asset to this program*
Reference #1 Name*
Phone #*
Relationship*
Reference #2 Name
Phone #
Relationship
Reference #3 Name
Phone #
Relationship
Please Check off Which Session(s) You Wish to Work*

Full Session (6.20.22 - 8.11.22)Session I (6.20.22 - 7.15.22)Session II (7.18.22 - 8.11.22)
Signature*

Clear
Should be Empty: