Staff Application

Staff Application
Personal Information
Name*

First NameLast Name
Legal Name*
Gender*

MaleFemale
Date of Birth*

MonthDayYear
Date
Current School/Employer*
Current Grade/Position*
Do you have a valid drivers license?*

YesNo
Drivers License State*
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Home Phone Number*
Cell Phone Number*
Email*
example@example.com
How did you hear about us?*
Position Interested in applying for*
Other Position*
Available Dates:
From*

MonthDayYear
Date
To*

MonthDayYear
Date
Would you be interested in staying for our additional week 7 bonus week?

YesNoMaybe
Are you applying with a group?*

YesNo
Please list group*
Please list group*
Would you come without your group?*
Are you vaccinated for Covid 19?*
Please explain*

Experience
Past Camp History
Provide a record of your most recent camp history (camper or staff). Include all information including dates, camp, position and names and contact info of supervisor.
Camp Experience*
Year*
Camp Name*
Director Name*
Phone Number*
Position*
Camper, CIT, etc.
Year
Camp Name
Director Name*
Phone Number*
Position
Camper, CIT etc.
Year
Camp Name
Director Name*
Phone Number*
Position
Camper, CIT etc.
Work History
Please provide details on any other work experience that you may have.
Work History
Dates
Employer
Name & Contact info of direct supervisor
Position
Dates
Employer
Name & Contact info of direct supervisor
Position
Dates
Employer
Name & Contact info of direct supervisor
Position
References
Please provide at least two references (not relatives) who have knowledge of your character, experience, work habits and ability.
References*
Name*
Phone Number*
Email*
example@example.com
Name*
Phone Number*
Email*
example@example.com
Name
Phone Number
Email
example@example.com
CPR/First Aid Certification*

I am certified in CPR/First AidI am not certified in CPR/First Aid
Lifeguard/Swim Instructor*

I am a certified lifeguardI am a certified swim instructorI am both a certified lifeguard and swim instructorI am neither a lifeguard or swim instructor

What would you like to accomplish this summer at Camp Gan Israel?
Please share any special talents or skills you have that you can use in camp
Are there any activities you specifically enjoy? (Like dance, drama, art...) Do you play an instrument?
Are there any details we should know about you and your work habits?
(This can include allergies, illnesses, special food requirements, likes and dislikes or anything else we should know about you. Please elaborate)

Legal
Have you ever been accused of harassment of any person including, but not limited to, workplace harassment?*

YesNo
Please explain*
Criminal Record - Have you ever been convicted of a crime, other than a minor traffic offense?*

YesNo
Please explain*
Authorization to Invest
I authorize investigation of all statements herein, including any checks of criminal records, and release the camp and all others from liability in connection with same. I understand that, if employed, I will be an at-will employee unless there is an agreement or law which alters that status. Furthermore, I understand that any agreement must be in writing and signed by the designated camp official. I also understand that untrue, misleading, or omitted information herein or in other documents completed by the applicant may result in dismissal, regardless of the time of discovery by the camp.
Signature*

Clear
Should be Empty:

Legal