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Staff Member Application

Staff Member Application

Apply Now for An Experience of A Lifetime!

To Apply for a Counselor Position in Camp Gan Israel at Chestnut Hill
please fill out the following form:

I: General Information
Name
  First
Middle
Last
Position Applying For
  Other
  
Present Mailing Address
  Street
City
State
Permanent Mailing Address
  Street
City
State
Phone 
     
Birthdate
  Yes, I am under 18 years of age

Sex

   
SS #   I am legal to work in the US Yes No  
Contact Info
  Cell Phone
Email
 
Present Occupation
 
(if not in school)
   
How did you hear about this position?   Please be specific
     
II: Education
High School   Dates Attended
Did you graduate
Yes No
College/
Seminary
  Dates Attended
Did you graduate
Yes No
Other
   Licenses, certificates, etc
 Jewish Education  
     
III: Work Experience
Record ALL work experience, including jobs held while attending school. You may include any work performed on a volunteer basis. LIST MOST RECENT JOB FIRST.
Employer   Dates Employed:  
 Address   Phone Number:
  Job Title     Supervisor  
State major responsibilities       
         
Employer     Dates Employed:  
 Address     Phone Number:  
  Job Title     Supervisor  
State major responsibilities      
         
Employer     Dates Employed  
 Address     Phone Number  
Job Title     Supervisor  
State major responsibilities        
         
List groups or organizations to which you belong.  List leadership positions held, if any   
     
List hobbies and interests     
    May we contact your present employer at this time? Yes No 
     Was your employment ever terminated involuntarily or were you ever asked to resign?Yes No 
     If yes please explain:
    Have you ever been arrested, charged, or convicted of sexual abuse of a minor or child molestation? Yes No 
    If yes please explain:
     
IV: Skills     
    Rate the following activities as follows.  (1) can teach as an expert. (2) can assist the teacher and assume some responsibility. (3) generally familiar. (4) unfamiliar
 Frisbee    Board Games  Israeli Dance  Modern Dance
 Drama    Arts and Crafts    Jewelry Making  Sewing
 Knitting    Woodworking  Song Leading  Photography
 Basketball  
 Soccer  Street Hockey  Golf
 Tennis     Yoga  Red Cross W.S.I  Fluent in Hebrew  
     Fluent in other languages   C.P.R. training completed   
         

Age Preference
(rank in order; 1,2,3 etc.)
 

   2.5-3 years old
 3-4 years old
 4-5 years old
 6-8 years old
 8-12 years old
 13-14 years old
   
         
V: References
List 3 references who could comment on your abilities and experience working with children.
1. Reference Name     
Address     
 Phone Number    
2. Reference Name     
Address    
Phone Number    
3. Reference Name      
Address      
Phone Number    
     
VI: Applicant’s Certification and Agreement 

I understand that if I am hired I am required to abide by the rules and regulations of Camp Gan Israel at Chestnut Hill.  I understand that I will be employed on an at-will basis, which means that I will be free to resign at anytime, and that camp Gan Israel at Chestnut Hill reserves the right to terminate the employment at any time, with or without cause regardless of the date of payment of my wages and salary.

The information I have supplied in this application or as part of the application process is true and complete.  I understand that any false statements or significant omissions by me in the application or application process may be cause for dismissal if discovered at a later date.

I hereby authorize Camp Gan Israel at Chestnut Hill to investigate the information I have furnished on this application, as well as conduct a CORI background check.

Date:    Initials:  Agree: Yes No


 

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