Staff Application

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APPLICANT’S FULL NAME

URJ Camp Institutes NFTY in Israel Programs Mitzvah Corps

DATE

Application for Summer Staff Position RETURNING STAFF Please complete the separate Returning Staff Application, which is available from your Camp or online at www.urjcamps.org

Please send this application directly to the camp or program of your choice. However, if you wish to apply to several Camp Institutes and/or NFTY Israel Programs, or if you have no preference, please send this application to the Union for Reform Judaism Youth Division. Your application will only be considered by one camp at a time. Please number your choices in order of preference. URJ CAMPS ___ URJ Camp Coleman (Cleveland, GA) Winter Address: 1580 Spalding Drive • Atlanta, GA 30350 770.671.8971 • Fax: 770.671.0241 [email protected] ___ URJ Crane Lake Camp (West Stockbridge, MA) Winter Address: 301 Route 17 N • Rutherford, NJ 07070 201.804.9700 • Fax: 201.804.9785 [email protected] ___ URJ Eisner Camp (Great Barrington, MA) Winter Address: 301 Route 17 N • Rutherford, NJ 07070 201.804.9700 • Fax: 201.804.9785 [email protected] ___ URJ Camp George (Parry Sound, ONT) Winter Address: 3845 Bathurst St, Suite 301 Toronto, ONT. Canada M3H 3N2 416.638.2635 • Fax: 416.638.8803 [email protected]

___ URJ Goldman Union Camp Institute 9349 Moore Road • Zionsville, IN 46077 317.873.3361 • Fax: 317.873.3742 [email protected] ___ URJ Greene Family Camp 1192 Smith Lane • Bruceville, TX 76630 254.859.5411 • Fax 254.859.5225 [email protected] ___ URJ Camp Harlam (Kunkletown, PA) Winter Address: 1511 Walnut St., Suite 401 Philadelphia, PA 19102 215.563.8184 • Fax: 215.563.1549 [email protected] ___ URJ Jacobs Camp P.O. Box 327 • 3863 Morrison Road Utica, MS 39175 601.885.6042 • Fax: 601.885.6269 [email protected]

___ URJ Camp Kalsman (Arlington, WA) Winter Address: 600 Stewart Street, Suite 838 Seattle, WA 98101 206.443.8340 • Fax: 206.770.9457 [email protected] ___ URJ Kutz Camp (Warwick, NY) Winter Address: 633 Third Avenue, 7th Floor New York, NY 10017 212.650.4070 • Fax: 212.650.4199 [email protected] ___ URJ Olin-Sang-Ruby Union Institute (Oconomowoc, WI) Winter Address: 555 Skokie Blvd., Suite 333 Northbrook, IL 60062 847.509.0990 • Fax: 847.509.0970 [email protected] ___ URJ Camp Newman–Swig (Santa Rosa, CA) Winter Address: 235 Montgomery St., Suite 1120 San Francisco, CA 94104 415.392.7080 • Fax: 415.392.1182 [email protected]

Current as of October 2008 UNION FOR REFORM JUDAISM, YOUTH DIVISION 633 Third Avenue, 7th Floor New York, NY 10017 212.650.4070 • Fax: 212.650.4199 • [email protected]

___

Mitzvah Corps 633 Third Avenue, 7th Floor New York, NY 10017 212.650.4071 • Fax: 212.650.4199 [email protected]

___

NFTY in Israel Programs New York Office NFTY in Israel Programs 633 Third Avenue, 7th Floor New York, NY 10017 212.452.6517 • Fax: 212.650.4199 [email protected]

___

Jerusalem Office NFTY in Israel 13 King David Street Jerusalem 94101, Israel 011-972-2-624-6195 • Fax: 624-1295 [email protected]

North American staff applications for NFTY in Israel Programs should be sent to the New York office.

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FOR OFFICE USE ONLY

UNION FOR REFORM JUDAISM Camp-Institute, ___________________________ NFTY in Israel Programs Mitzvah Corps

Date Application Sent _____________ Date Application Recd. ____________ Date Contract Sent _______________

PHOTO (Required) For Identification

Date Contract Recd._______________

Purpose Only

APPLICATION FOR STAFF POSITION

Date Program Material Sent ________ (Please print all information)

Position Applying For: ________________________________________________________________________

Date of Application: ___________________________

Dates available for summer position: _____________________________________________________________________________________________________________

PERSONAL DATA Full Name _____________________________________________________________ Gender: Are you 18 or older (as of June 1, 2009)?

Yes

No

M

Are you 21 or older (as of June 1, 2009)?

F Yes

Circle T-shirt Size: S M L XL XXL No

Permanent Address____________________________________________________________________________________

Phone _______________________________

Street #

__________________________________________________________________________________________________________________________ Zip/Postal Code

City & State/Province

Present Address

___________________________________________________________________________________

Phone _______________________________

Street #

__________________________________________________________________________________________________________________________ Zip/Postal Code

City & State/Province

Until what date is the present address valid? ________________

Address as of May-June:

Permanent

Present

E-mail address:_____________________________________________ Cell Phone ________________________________ Work Phone _____________________________ If you are hired, will you require housing for any person(s) other than yourself at camp?

Yes

No

Can you perform the essential functions of the job for which you have applied, with or without reasonable accommodation?

Are you legally eligible for employment in the USA?

Yes

No Are you legally eligible for employment in Canada?

Yes

Yes

No

No

If you are not currently legally eligible for employment in the country where you are seeking employment, are you willing to apply for a Visa/Work Permit?

Yes

No

Answer these questions only if applying for a position requiring driving: Do you have a valid driver’s license?

Yes

Do you have a current chauffeur’s type license?

No If yes, what State/Province/Country? ____________________________________________________________________ Yes

No Do you have a commercial driver’s license?

Yes

No

CERTIFICATIONS CERTIFICATION

ISSUED BY (eg, ARC, AHA, CRC)

EXPIRATION DATE

Lifesaving/Bronze Shield WSI Pool Operator First Aid CPR Small Crafts Ropes Course/Outdoor EMT Other:

2

TYPE

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EDUCATIONAL AND JUDAIC BACKGROUND Name of High School ____________________________________________ City and State/Province _____________________________________ Graduation Year _________ Name of College/University _________________________________________________ City and State/Province _________________________________________________ Major/Degree/Area of Study _________________________________________________ Graduation Date/Expected Graduation Date __________________________________ Name of Post Graduate Institution ____________________________________________ City and State/Province _________________________________________________ Major/Degree/Area of Study _________________________________________________ Graduation Date/Expected Graduation Date _________________________________

Bar/Bat Mitzvah

Yes

No Confirmation

Yes

No

Hebrew Teacher Certification

Yes

No

Religious School Teacher Certification

Yes

No

Synagogue: __________________________________________________ City and State/Province ____________________________________________________________ Movement Affiliation: Reform

Conservative

Have you ever been to Israel?

Yes

Reconstructionist

Orthodox

Other

No if yes, what program(s)? __________________________________________ length of program(s) ____________________

Please describe your Hebrew proficiency

Beginning (B)

Intermediate (I)

Advanced (A)

Speak ______

Read ______

Write ______

None

Describe formal Hebrew and Jewish Academic training _______________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________ Camp experience: Camp 1 Name ________________________________________________________ Location ________________________________________________ Programs Participated in: __________________________________________________ Years Attended: ______________________ Camper

C.I.T.

Staff

Faculty

Camp experience: Camp 2 Name ________________________________________________________ Location ________________________________________________ Programs Participated in: __________________________________________________ Years Attended: ______________________ Camper

C.I.T.

Staff

Faculty

List any youth group/informal education experience (as a participant) ___________________________________________________________________________________ Skills, Interests, Abilities: Check items in which you have some skill. Double check those you are proficient in and can teach or lead. Music Arts/Crafts Ropes Course Canoeing Aerobics Song Leading Ceramics Rock Climbing Windsurfing Archery Choir Photography Nature Water-skiing Basketball Israeli Dance Video Campcraft Canoe Tripping Inline Skating Modern Dance Creative writing Office skills Sailing Mtn. Biking Drama Radio Typing Swimming Riding Theater (tech.) Journalism Computer Kayaking Roller Hockey Are you interested in working with children with special needs? Do you play a musical instrument?

Yes

Yes

Soccer Softball Tennis Volleyball Sports (please list): _____________________ _____________________

No

No (If so, which one)_______________________________ With children of what ages do you work best? _____________

Describe any leadership positions you have held ____________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________

GENERAL EMPLOYMENT EXPERIENCE Employer _____________________________________________________________________________________

Phone _____________________________________

Full Address ___________________________________________________________________________________

Fax________________________________________

Position ________________________________

Dates _______________

Salary ________________

Immediate Supervisor ________________________________

Describe responsibilities of position ______________________________________________________________________________________________________________ Reason for leaving____________________________________________________________________________________________________________________________

Employer _____________________________________________________________________________________

Phone _____________________________________

Full Address ___________________________________________________________________________________

Fax________________________________________

Position ________________________________

Dates _______________

Salary ________________

Immediate Supervisor ________________________________

Describe responsibilities of position ______________________________________________________________________________________________________________ Reason for leaving____________________________________________________________________________________________________________________________ 3

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JEWISH TEACHING/YOUTH WORK HISTORY School/Congregation __________________________________________________________________________________________________________________________ Full Address ___________________________________________________________________________ Phone _______________________________________________ Position ________________________________

Year ________________

Salary ________________

Supervisor _________________________________________

Responsibilities ______________________________________________________________________________________________________________________________

School/Congregation __________________________________________________________________________________________________________________________ Full Address _____________________________________________________________________________ Phone _____________________________________________ Position ________________________________

Year ________________

Salary ________________

Supervisor _________________________________________

Responsibilities ______________________________________________________________________________________________________________________________

REFERENCES List three people, other than relatives or personal friends, who know you personally. One should be someone who has worked with or supervised you in a Jewish setting, if possible. Please give complete names and addresses. Name ________________________________________________________________________________________

Phone _____________________________________

Address ______________________________________________________________________________________

E-mail _____________________________________

Name ________________________________________________________________________________________

Phone _____________________________________

Address ______________________________________________________________________________________

E-mail _____________________________________

Name ________________________________________________________________________________________

Phone _____________________________________

Address ______________________________________________________________________________________

E-mail _____________________________________

QUESTIONNAIRE Please use additional page CAMP INSTITUTES APPLICANTS

NFTY IN ISRAEL PROGRAM APPLICANTS

MITZVAH CORPS APPLICANTS

1.

1.

1.

2. 3. 4. 5.

What impact do you hope to have on a young person’s camp experience? Please explain what you would like to contribute to Reform Jewish camping. What particular strengths do you feel you have that you would bring to the position? What do you hope to gain from this experience? What event, person or experience has had the greatest impact on your Jewish life?

2. 3. 4. 5.

What impact do you hope to have on a young person’s Israel travel experience? Why is it important for teens to be part of a summer Israel travel experience? What particular strengths do you feel you have that you would bring to the position? What do you hope to gain from this experience? What event, person or experience has had the greatest impact on your Jewish life?

2. 3. 4. 5.

What impact do you hope to have on a young person’s Mitzvah Corps experience? Why is it important for teens to be part of a summer Mitzvah Corps experience? What particular strengths do you feel you have that you would bring to the position? What do you hope to gain from this experience? What event, person or experience has had the greatest impact on your Jewish life?

1.

Have you ever been charged with or convicted of a misdemeanor? Yes No (if yes, please provide details) _______________________________________________________________________________________________________________

2.

Have you ever been charged with or convicted of a felony? Yes No (If yes, please provide details) _______________________________________________________________________________________________________________

3.

Have you ever been charged with, or found guilty of committing an act of physical, sexual or any other type of child abuse? Yes No (If yes, please provide details) _______________________________________________________________________________________________________________

I authorize the URJ and/or its agents to conduct an independent background investigation of me. I further authorize the URJ and/or its agents to request or receive any information pertaining to me including criminal, motor vehicle reports, past employments, education and/or references from any persons, schools, previous employers, or publicly accessible internet websites. I acknowledge that this information may be used by the URJ and/or its agents throughout my hiring process. If you have not lived at the permanent address you listed for at least one year, please enter your previous address below: Previous Address ___________________________________________________________________________________________________________________________________ City & State/Province ________________________________________________________ Zip/Postal Code __________________________________________________________ Signature _____________________________________________________ Date _______________________ SS#/SI#: ________________________________________________ 4