Staff Application Step 1 of 6 16% Personal InformationName* First Last Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email* Enter Email Confirm Email Cell Phone*Home PhoneAddress Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Opportunities in CampNJY Camps is comprised of several camps in two location. If you prefer to be considered for employment at a specific camp(s), please check all that apply so that we can route your application to the approriate camp director(s).* No Preference Camp Shoshanim (Girls' Orthodox) Lake Como, PA Camp Nesher (Co-ed Modern Orthodox) Lake Como, PA Camp Nah-Jee-Wah (1st through 6th Grades) Milford, PA Cedar Lake Camp (7th, 8th, 9th Grades) Milford, PA Teen Camp (10th and 11th Grades) Milford, PA Round Lake Camp (Special Needs Inclusion) Milford, PA Why do you want in work in camp, and in what position?*Which LEARNING positions are in your skill set? (Check all that apply) Chinuch Beit Medrash Program (BMP) Informal Education Leadership Training Which SPORTS positions are in your skill set? (Check all that apply) Archery Backyard Games Badminton Baseball Basketball Batting Cage Circuit Training Fencing Field Hockey Flag Football Frisbee Golf Ga-Ga Golf Gymnastics Lacrosse Marathon/Running Martial Arts Pilate Ping Pong Roller Hockey Skateboarding Soccer Softball Tennis Ultimate Frisbee Video Sports Volleyball Weight Training Zumba Other Which ARTS & CRAFTS positions are in your skill set? (Check all that apply) General A&C Beading Candle Making Ceramics Hand Building Ceramics Wheels Creative Arts Fashion Design Filmmaking Guitar Jewelry Knitting Model Airplanes Model Making Newsletter Painting and Drawing Photography Digital Photography Film Woodshop Other Which PERFORMING ARTS positions are in your skill set? (Check all that apply) Acting Ballet Choreography Drums DJ Guitar Hip Hop Improv Recorder Israeli Dance Jazz Dance Modern Dance Piano/Keyboard Singing Song Leader Set Design Other Which ADVENTURE/ROPES positions are in your skill set? (Check all that apply) High Ropes Hiking Low Ropes Mountain Biking Orienteering Rock Climbing Other Which WATERFRONT positions are in your skill set? (Check all that apply) Canoeing Jet Ski Kayaking Sailing Swim Team Coach Water Polo Windsurfing Lifeguard WSI Other Lifeguard Certification Expiration DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920WSI Expiration DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Which SCIENCE positions are in your skill set? (Check all that apply) Astronomy Biology Chemistry Kinesiology Physics Robotics Other Which OTHER PROGRAM positions are in your skill set? (Check all that apply) Animal Center Babysitter Chess Computers - MAC Computers - PC Culinary Arts/Cooking Day Camp Counselor Farming Fishing Horseback Riding Israeli Culture Strategy Games Other Which SERVICE/SUPPORT positions are in your skill set? (Check all that apply) Accounting Cleaner Data Entry Driver Food Service Maintenance - Building Maintenance - Vehicles/Boats Medical - Administrator Medical - Nurse Medical - Physician Office Other Other Jobs, not covered by listing More About YouWhat is your primary Spoken language?EnglishHebrewSpanishRussianFrenchChineseAdditional Languages Spoken With Fluency (Check all that apply): English Hebrew Spanish Russian French Chinese Other Other Additional Languages Spoken With FluencyI am available to work from:Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920to:Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920If you were referred to the NJY Camps, please tell us who referred you: Education and EmploymentWhat do you presently do full time?Employment History (List from Most Recent):Employer NameLocationDatesSupervisor Name & PhoneBrief Work Description Name of High SchoolCurrent Status - High SchoolGraduatedSenior (12th Grade)Junior (11th Grade)Date of Graduation - High SchoolMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Expected Date of Graduation - High SchoolMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Name of Undergraduate Institution:Current Status - UndergraduateFreshman (1st Year)Sophomore (2nd Year)Junior (3rd Year)Senior (4th Year)Super-senior (5th Year)GraduatedExpected Date of Graduation - UndergraduateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Date of Degree - UndergraduateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Major Field(s) of Study - UndergraduateName of Graduate InstitutionMajor Field of Study - GraduateDate of Degree or Expected Date of Degree - GraduateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Type of Degree - GraduatePlease list any professional/academic certificaions or awardsName of Certification/AwardDate Received Please list any volunteer work, clubs, hobbies, intermural sports, etcName of ActivityCategory (Volunteer, Club, Hobby, Sport, etc)Length of Time References - Please provide three professional references - NOT relatives - who can comment on job/character/reliability/academic abilityReference 1Name* First Last Relationship to YouReference #1 Email Address* Reference #1 Phone Number*Reference 2Name* First Last Relationship to YouReference #2 Email Address* Reference #2 Phone Number*Reference 3Name* First Last Relationship to YouReference #3 Email Address* Reference #3 Phone Number* Have you ever been charged or convicted of a felony or misdemeanor?*NOYESIf yes, please explainHave you ever been charged or convicted of a crime involving physical, sexual or mental abuse of a child or adult?*NOYESIf yes, please explainPlease upload a recent picture of yourselfAccepted file types: jpg, png, gif, pdf.By pressing SUBMIT on this application, I am confirming the accuracy of the information provided. I give permission for any employment record, motor vehicle record and references to be checked by an outside reporting agency. If you wish to withhold this permission explain, why:
