Full Name *

E-mail Address *

Female * Male *

Current Address *

Current Phone *

City *	State *	Zip *

My permanent is the same as my current address.

Permanent Address *

Permanent Phone *

City *	State *	Zip *

Cell Phone

I am currently a: * Freshman Sophomore Junior Senior Other:

Attending: * College High School Other:

Name Of School *

If College, My Major Is:

I have been bar/bat Mitzvah'd: * PLEASE SELECT Yes No

I attended Hebrew/Jewish School: * PLEASE SELECT Yes No

What Is Your Jewish Background?

I am applying for: * Senior Counselor (College +) Specialist Junior Counselor (High School Senior) Masada Counselor Unit Head Area Director

Which age group do you think you work best with? * 8-10 year olds 11-12 year olds 13-14 year olds 15+ years

Would you be interested in working with campers with special needs?: * Yes No

The area(s) I would like to work. * Beside each item check off: 3 if you are appropriately skilled to teach 2 if you can assist others 1 if you have no skill or interest. + All Waterfront Areas Require Lifeguard Certification
1 2 3 Waterskiing + Sailing + Pool + Swim Dock + Drama Outdoor Education Judaic Specialist Song Leader	1 2 3 Ropes Course Archery Mountain Biking Arts & Crafts Fishing Photography Landsports: (soccer, football, softball, basketball, tennis)

Please list any certification you will hold during the summer (i.e. CPR, First Aid, Ropes Cert., etc.):

Do you have any experience working with children? * PLEASE SELECT Yes No
If Yes, please list:

Have you ever worked in a camp setting? * PLEASE SELECT Yes No
If Yes, please list:

Are you involved in any extra-curricular activities? (sports, clubs, community service, etc):

How did you hear about Camp Sabra? Friend Relative Newspaper Camp Channel Internet College Fair American Camp Association

Why are you applying for a job at Camp Sabra? *

What would a child gain from you during the summer? *

Please list three references in full (at least one work and one personal):

Type	Name	Title	Address	Number	Company/Relation
1. Work: *
2. Personal: *
3. SELECT Work Personal

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will result in (i) no further consideration of this application, or (ii) immediate discharge, whenever it is discovered.