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Date: ______________
Last Name: _________________________________________ First Name: ___________________________________
Address: ______________________________________________________ Zip Code: ___________________________
Phone: _________________________________________ Email Address: ____________________________________
Name of School Currently Attending: _______________________________Entering Grade: ____________________
Date of Birth: ______________________________________
Please list any previous experience. (camps, youth groups, etc.)
Organization: __________________________________________________________________________________
Position: _______________________________________________ Year: __________________________________
Organization: ___________________________________________________________________________________
Position: _______________________________________________ Year: __________________________________
Name of two adult references (other than relatives)
Name: _________________________Relationship: ___________________ Phone: ____________________________
Name: _________________________Relationship: ___________________Phone: ____________________________
Which trips are you applying for? (Please check) _______First Trip (June 25-July 20), _________Second Trip (July 23-August 15), _______Both Trips
Please list any courses or certificates completed in first aid, swimming, etc.
_______________________________________________________________________________________________
What specialties or talents can you bring to this job?
_______________________________________________________________________________________________
Camp Revach reserves the right to place you in whatever bunk we see fit. Camp Revach cannot take any requests of which bunk you would like. Placement of staff members are not placed by age.
As a Camp Revach staff member you will be expected to dress within the strictest standards of tznius. Shirts and tops must cover your collarbone and elbows at all times and may not be too form-fitting. Skirts may not be tight and must cover your knees while sitting, standing, and walking. Your legs must be covered at all times.
Signature: ______________________________________________________________________________________
Once Camp Revach receives your application a response will be sent to you to let you know it has been received. Should you be hired as a staff member you will receive a written contract. At any point you may reach us via email at [email protected]
Office use only: Date Submitted:
