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Staff / Staff Application

 Important Information

 Staff Application

 2012 Staff
This form must be completed by all staff interested in working at Camp Hatikvah.
Please print, sign and mail this form to our office or press submit and it will be sent directly to the Camp Director.

Camp Hatikvah
1-5763 Oak St.
Vancouver, BC, V6M 2V7

Fields marked with * are mandatory


GENERAL INFORMATION

Name: *
Gender : Male Female *
Birthdate (mm/dd/yyyy): *
Social Insurance Number: *
Medical Insurance Number: *
Home Address: *
City: *
Postal Code: *
Home Phone Number: *
Cell Phone Number:
Temporary/University Address: *
Temporary/University Phone: *
E-Mail Address:

EMERGENCY INFORMATION

In case of emergency contact:
Relationship to you:
Home Phone:
Work Phone:
Cell Phone:

EDUCATION AS OF JULY 1

(Please list each camp on a separate line)
Year(s), Institution, Degree or Major

CAMPING BACKGROUND AS A CAMPER

(Please list each camp on a separate line)
Name of Camp, Years Attended

CAMPING BACKGROUND AS A STAFF MEMBER

JEWISH YOUTH EXPERIENCES

WORK EXPERIENCES

VOLUNTEER EXPERIENCES

(Please list each organization on a separate line)
Organization, Position(s) Held, Year, Contact Number

ACTIVITIES OF SPECIAL INTEREST

Scouting Drama
Canoeing/Kayaking Arts and Craft
Waterskiing Shabbat programming
Sailing Staff Programming
Israeli Folk Dancing Shabbat Services
Sports Swimming
Guitar Music

Please give examples and specifications where applicable regarding the activities you have checked:

CERTIFICATIONS:
Certifications must be valid for Summer 2012:
Financial compensation based on certification

National Lifeguard Service (NLS) American Lifeguard Service (ALS)
Lifeguard/Water Safety Instructor (LSI - WSI) Occupational First Aid 1 (OFA)
Emergency First Aid Occupational First Aid 2 (OFA)
Cardiopulmonary resuscitation (CPR) Occupational First Aid 3 (OFA)
Wilderness First Responder (WFR) Boat Driver’s License
Other

 

REFERENCES

Please provide three references (non-relatives) who are familiar with your leadership, work and camp experience
(e.g. camp directors, supervisors, employers)

Name, Phone, Organization, Position

(1)
(2)
(3)
   

Please tell us why you would like to become a staff member at Camp Hatikvah and what you see as your strengths and weaknesses. How did you hear about our program?

   

Are there any disabilities that would prevent you from fully participating in this program?

   

Have you applied to any other Young Judaea camps? If yes, please specify:

Yes No
   

I hereby declare that the information given above is complete and correct to the best of my knowledge and belief.  I understand that if I am employed, falsified statements on this application shall be considered sufficient excuse for dismissal.
Name of applicant:
Application Date:
 
Please attach any additional information such as a
resume and send into our office.

By clicking on the "Submit Application" button, I am aware that if I submit any false information it may lead to the dismissal of my application.
 

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1-5763 Oak St., Vancouver, BC, V6M 2V7 p: 604-263-1200
email: admin@camphatikvah.com | site by Juice

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