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Camp Moshava 2017 Staffing Application
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* Indicates required question
Name
*
Your answer
Grade Entering in Fall 2017 (If in Middle/High School)
Your answer
If post High School - What is your current occupation?
Your answer
Date of birth
Your answer
Address
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Preferred age group
*
If choosing specialist, please indicate focus in Notes below
EC15
2's
3's
4's
K
1st - 3rd
4th - 6th
Specialist
Other:
Required
Notes
Your answer
I am available to work
*
Full Day (8:30 - 4:00)
Half day (8:30 - 12:00)
I would like to work the following weeks of camp
Weeks 1-4
Weeks 5-7
All 7 Weeks
Other:
Clear selection
I have a current CPR certification
*
Yes
No
T-Shirt Size
S
M
L
XL
Other:
Clear selection
I want to work for community service hours
Middle Schoolers (grades 7-8) can only work for community service hours!
No Thanks
For 1 week
For 2 weeks
For 3 weeks
Clear selection
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