Your Information
* Required Fields

* Name	*(Last)   *(First)
Position applying for
* Current Address	*Country
* City	* State/Province * Zip
* Current Phone
Cellular Phone
* Permenant Address	Country
City	State/Province   Zip
Personal Profile URL Information
* Permenant Phone
E-mail	* Grade Male Female
Driver's License Number	State   Social Security #
	Have you ever been convicted of a crime?   Yes   No   If yes, continue below
	If so, when, where & nature of crime
	Are there any felony charges pending against you?   Yes   No

I understand that this organization has the right to secure criminal history as part of their pre-employment screening process using the information provided above. I authorize Camp Lakeland to utilize the above information for the sole purpose of obtaining a criminal history file search. All information provided on this application form is true to the best of my knowledge. 

* I have read and understand the paragraph above

Formal Education

	High School
Name of High School	Location
Major Studies Area	Year in school (i.e. Freshman, etc.)
Graduation Date
	Jewish Education
Name of School	Location
Major Studies Area	Year in school (i.e. Freshman, etc.)
Graduation Date
	College
Name of School	Location
Major Studies Area	Year in school (i.e. Freshman, etc.)
Graduation Date
	Graduate Work
Name of School	Location
Major Studies Area	Year in school (i.e. Freshman, etc.)
Graduation Date

References
(Present or former employer, school advisor, camp supervisor. Do not use friends or relatives)
Fill out at least three.

Reference #1
Name
Phone	Relationship to Reference
Address
City	State   Zip
Reference #2
Name
Phone	Relationship to Reference
Address
City	State   Zip
Reference #3
Name
Phone	Relationship to Reference
Address
City	State   Zip

Camper Experience

Name of Camp #1	Age
Year	Length of Program
Name of Camp #2	Age
Year	Length of Program

Activities
In the following section, please check those activities which you are able to organize, teach, assist in teaching, or have some useful experience in. 

Sports	Waterfront	Dance	Pioneering/Outdoors
Archery Basketball Softball/Baseball Group/New Games Gymnastics Ga Ga Floor Hockey Horseback Riding Soccer Tennis Volleyball Other	Waterfront Swimming Synchronized Swimming Diving Sailing Windsurfing Waterskiing Canoeing Lifesaving Water Safety Instructor Other	Modern  Jazz Aerobic Ballet Choreography Other	Camp craft Fire Building Outdoor Cooking Rock Climbing Overnight Tripping Forestry Backpacking Lashing/Construction Knot Tying Ropes Course Other
Arts & Crafts	Music	Entertainments	Nature/Science
Drawing Cartooning Painting Weaving Ceramics/Pottery Handicrafts Beading Basketry Woodworking Leather Metal/Smithing Sewing Macrame Paper Mache Copper Enamel Puppetry Jewelry Other	Song Leading  Piano Play By Ear Accompany Sight Read  Instruments Guitar Piano Drums Other	Videography Creative Dramatics Acting Directing Stagecraft Storytelling Digital Photo Skits/Stunts Other	Animals Birds Nature Study Ecology Animal Care Astronomy Other  Camp Power Kitchen Clerical Cleaning Other
Jewish Programming
Leading Services Hebrew Language Customs/Ceremonies Hebrew Songs Other Miscellaneous E.M.T. First Aid C.P.R. Other	Please list and describe any additional skills not listed		Please list any certificates in the above categories that you currently hold

Questions
Please answer all the questions below.
Note: Maintenance, Food Service, and other non-program staff need not answer these questions.

1) Why are you interested in working at Camp Lakeland this summer? How did you hear about us?

2) What personal characteristics, past experiences, training, skills, or talents do you have that would help you to be successful in the position for which you are applying?

3) How do you feel you can specifically help us fulfill our Jewish program goals on the individual camper level and on a group level?

4) What age group are you primarily interested in working with, and why?

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