Full Name

E-mail Address

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

Why are you applying for a job at Camp Sabra?

I am currently a Freshman Sophomore Junior Senior Other:

Attending: College High School Other:

Name Of School

If College, My Major Is:

I am applying for: SCT (High School Senior) Specialist (High School Graduate +) Counselor (High School Graduate +) Masada Counselor (21+ preferred) Unit Head (21+ preferred) Area Director (21+ preferred) I Don't Know Yet

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

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	1 2 3 Song Leader Ropes Course Archery 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.):

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

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

What would a child gain from you during the summer?

Please list extracurricular activities you are involved in (sports, clubs, community service, etc):

Please list your work history:

Please list three references in full (one work, one personal, one additional):

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

If employed, and you are under 18, can you furnish a work permit?
PLEASE SELECT Yes No

Have you filed an application with the St. Louis JCC or Camp Sabra before?
PLEASE SELECT Yes No

Have you ever been employed by the St Louis JCC or Camp Sabra before?
PLEASE SELECT Yes No

Are you employed now?
PLEASE SELECT Yes No

May we contact your present employer?
PLEASE SELECT Yes No

Are you a US citizen or can you establish that you are an authorized worker?
PLEASE SELECT Yes No

Have you ever been convicted of, or pled guilty or nolo contender to any crime (other than a minor traffic violation)?
PLEASE SELECT Yes No
If yes, please explain (Note that conviction of a crime will not necessarily disqualify an applicant. The nature of the crime and when the conviction occurred will be considered).

Do you have the physical ability to perform all essential duties of the job(s) for which you are applying? PLEASE SELECT Yes No
If No, please explain:

Are there workplace accommodations which would assure better job placement and/or enable you to perform your job to your maximum capability?
PLEASE SELECT Yes No
If Yes, please indicate:

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

Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a disability or handicap.

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application or any other pre-employment documents shall result in termination when discovered. I authorize you to obtain an investigative consumer report and/or a report from any law enforcement agency which may include both general and personal information about me. I authorize investigation of all statements contained herein and authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.

In consideration of my employment, I agree to conform to the rules and regulations of the Center and agree that, except to the extent provided by an applicable collective bargaining agreement or other contract providing to the contrary, my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either the Center or myself and without notice or liability for wages or salary except such earned at the date of such termination.

In the event that I am employed, I understand that regardless of the shift and job that I am first assigned, I may be required to accept a change of job or shift depending on my demonstrated skills after employment and the needs of the Center. I consent to take any physical or medical examinations, including blood and urine or other tests for alcohol and drugs, requested by the Center in connection with the processing of my application for employment and further agree to take any such physical or medical examinations requested by the Center during my employment if I am offered and accept a job when such examinations are job-related and consistent with business necessity. I understand that such an examination may be needed in order to determine my competence to perform the job or work for which I was hired, or to identify any physical or mental condition bearing on my job performance. I understand that refusal to submit to any physical or medical examination ordered by the Center will result in rejection for employment or for disciplinary action up to and including immediate discharge. I further understand that any information obtained through such exams may be retained by the Center and is exclusively the Center's property. I also understand that the examinations will be performed by medical personnel, clinics or laboratories qualified to do the necessary work and costs for such examinations will be borne by the Center.