Welcome to CMC >   Life at Camp >   Job Descriptions >   Staff FAQs >   Important Dates >   Camp Forms >   Apply Now >   VISIT OUR RETREAT CENTER WEBSITE	Camp Mountain Chai Staff Application * required fields    *First Name:    *Last Name:    Position Applying For:    Are you over 18?    Yes  No If yes, what is your age?    Date of Birth:    Gender:    Male  Female * Email Address:    * Cell Phone Number:    PERMANENT ADDRESS Street Address:    City:    State:    Zip Code:    Phone:    CURRENT ADDRESS At this Address until:    Street Address:    City:    State:    Zip Code:    Phone:    EDUCATIONAL BACKGROUND High School Name of Institution Years Attended Year Graduated Degrees Major Minor College/University Name of Institution Years Attended Year Graduated Degrees Major Minor Graduate Work Name of Institution Years Attended Year Graduated Degrees Major Minor Other Name of Institution Years Attended Year Graduated Degrees Major Minor CAMP EXPERIENCE As a Camper:   Name of Camp Location Age(s) Attended Year(s) Attended 1. 2. As a Staff Member:   Year(s) Name of Camp Position Salary Supervisor Phone# 1. 2. 3. PERSONNAL BACKGROUND Jewish Education:   School Location # Yrs Studied Graduation/Degree 1. 2. Jewish Knowledge: (Excellent, Good, Fair, Poor) History Customs Ritual Tradition Prayer Can you help prepare a Shabbat Service?    Yes   No Extra-Curricular Activities: Please describe any extra-curricular activities (ex. youth groups, athletics, school clubs, community service, volunteer work, etc.) and current organization affiliations. Describe any leadership positions held. Work Experience: (list all previous work experience)   Position Employer Address Dates Supervisor 1. 2. 3. CERTIFICATIONS (Please mail photocopies of all current certifications) Driver's License #:   State:   Expiration Date: First Aid, C.P.R. or B.L.S. (Please indicate certifications and expiration dates): Waterfront (Please check and indicate expiration date): A.L.S. W.S.I. Other (specify) SKILLS AND QUALIFICATIONS INVENTORY Considering the camp program and position applying for, Select "1" for those activities which you can organize and teach. Select "2" where you feel you can assist in teaching. Athletics ? 1 2 Archery ? 1 2 Basketball ? 1 2 Baseball ? 1 2 Mountain Biking ? 1 2 Fishing ? 1 2 Football ? 1 2 Golf ? 1 2 Karate/Judo ? 1 2 New Games ? 1 2 Soccer ? 1 2 Softball ? 1 2 Track and Field ? 1 2 Volleyball Other   Waterfront ? 1 2 Canoeing ? 1 2 Diving ? 1 2 Kayaking ? 1 2 Lifesaving ? 1 2 Snorkeling ? 1 2 Swimming ? 1 2 Water Polo Other Music Piano ? 1 2 Play By Ear ? 1 2 Accompany ? 1 2 Sight Read ? 1 2 Drums ? 1 2 Guitar ? 1 2 Rock Band Other ? 1 2 Songleading (camp songs) ? 1 2 Songleading (Hebrew songs) Arts and Crafts ? 1 2 Batik ? 1 2 Cartooning ? 1 2 Ceramics ? 1 2 Drawing ? 1 2 Handicrafts ? 1 2 Jewelry ? 1 2 Macramé ? 1 2 Painting ? 1 2 Paper Maché ? 1 2 Pottery ? 1 2 Sculpture ? 1 2 Sewing ? 1 2 Silkscreen ? 1 2 Weaving ? 1 2 Woodworking Other Outdoors Adventure ? 1 2 Backpacking ? 1 2 Camp Craft ? 1 2 Outdoor Cooking ? 1 2 Orienteering ? 1 2 Survival Skills ? 1 2 Knot Tying ? 1 2 Rock/Wall Climbing ? 1 2 Ropes Course ? 1 2 Hiking/Overnight Camping Other   Media ? 1 2 A-V Equipment Set-up ? 1 2 Computers ? 1 2 Creative Writing ? 1 2 Darkroom Developing ? 1 2 Internet ? 1 2 Newspaper ? 1 2 Photography ? 1 2 Radio Broadcasting ? 1 2 Lighting ? 1 2 Video Production Other   Nature/Science ? 1 2 Animals ? 1 2 Astronomy ? 1 2 Ecology ? 1 2 Nature Study Other   Dance ? 1 2 Aerobics ? 1 2 American Folk ? 1 2 Cheerleading ? 1 2 Ballet ? 1 2 Choreography ? 1 2 Jazz/Modern ? 1 2 International Folk ? 1 2 Israeli Folk Other   Drama/Performance Arts ? 1 2 Acting ? 1 2 Circus Arts ? 1 2 Costuming ? 1 2 Creative Dramatics ? 1 2 Directing ? 1 2 Juggling ? 1 2 Lighting ? 1 2 Music ? 1 2 Puppetry ? 1 2 Stage Craft ? 1 2 Storytelling ? 1 2 Skit and Stunts Other   Miscellaneous ? 1 2 CPR ? 1 2 First Aid ? 1 2 Typing ? 1 2 Leadership Training Other   Please list any activities or games you can teach that are not listed: Do you have or are you willing to obtain a commercial driver's license? I have a CDL with passenger endorsement. I am willing to obtain a CDL with passenger endorsement How did you find out about Camp Mountain Chai? REFERENCES Please include references who know of your qualifications and skills, or have supervised you in a professional capacity and can attest to your character. References who can evaluate your work with children, such as former employers, teachers, rabbis or school coun selors are preferred. Do not use relatives, friends or neighbors as references. Applications are not considered complete if a reference does not include a full mailing address and current telephone number. Please list at least three references.   Reference Name Your Relationship to Reference Known for How Long? Phone# Address 1. 2. 3. I hereby authorize CMC to check all my educational, personal, and employment references as indicated below. I further authorize these references to release to you all information they have about me. Signature (type your name) Date: Do you know of any reason why you would not be able to perform the essential functions of the position for which you are applying with or without reasonable accomodation? Yes   No If yes, please explain. MISCELLANEOUS INFORMATION Please describe how you would be able to positively affect the lives of our campers: This application is not a contract of employment. Please note that California is an at-will state. Have you ever been convicted of a crime? Yes   No If yes, please mail a separate sheet giving full details. I certify that the above information is true and accurate to the best of my knowledge. I understand that if employed, it will become part of my personnel file and that any misstatement of fact or falsification may be cause for my immediate dismissal. I also acknowledge that Camp Mountain Chai programs provide a smoke-free environment and that smoking is not permitted on camp grounds. I also understand that application to work at Camp Mountain Chai indicates my ability to refrain from smoking during my time in camp. I also give Camp Mountain Chai my permission to run a criminal background check. Signature (type your name) Date: Please type the letters shown in the box below:
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