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
Reference #2
Name
Phone	Relationship to Reference
Reference #3
Name
Phone	Relationship to Reference

Questions
Please answer all the questions below.

1) Why are you interested in returning to Camp Lakeland this summer?

2) What specialty area of camp would best suit you to work?

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

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