Please fill out all relevant information to the best of your ability. Incomplete applications may not be reviewed or accepted. All complete applications will undergo a careful review process, including reference checks. Inquiries can be sent to [email protected] or by whatsapp to 949.381.5610. I am applying to be a CounselorJunior CounselorHead CounselorDirector's AssistantCounselor's CounselorKitchen ManagerOther What job are you applying for? Personal Information Full Name First Name Last Name Address Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Current School Current Grade Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year If you are applying as a group, please list the other members of your group here. If you are part of a group, would you come if we do not accept every member of your group? YesNoMaybe Where did you hear about our camp? Parent's Names Parent's Contact Info Availability Are you taking the NY Regents? YesNo If so, what is the date of your last regent? 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Camp runs from June 22- August 14, with training starting Friday, June 20. Counselors who participate for the entire summer are entitled to the $800 stipend (and will be eligible for other paid jobs (bus monitoring, daycare, etc.). Other staff will get the regular $50 weekly stipend. Priority will be given to staff available all summer and/or staff who have been here before. I have looked through the dates of SGI and I am available throughout. YesNo Please note: At this time we are only considering staff available for the full summer. If not, I am available: Week 1 (June 22-26)Week 2 (June 29- July 3)Week 3 (July 6-10)Week 4 (July 13-17)Week 5 (July 20-24)Week 6 (July 27-July 31)Week 7 (August 3-7)Week 8 (August 10-14) References School Reference #1 Full Name Phone Number School Reference #2 Full Name Phone Number Camp this past summer (as camper or staff) Name of Camp Position Supervisor Phone Number Camp the summer before last (as camper or staff) Name of Camp Position Supervisor Phone Number Character References: Give names and contact information of 2 people (not related to you) who have knowledge of your character, experience, work habits and ability. Character Reference #1 Role Name & Phone Number Character Reference #2 Role Name & Phone Number A Bit About You What contributions do you think you can make at Silver Gan Israel? What are some things you enjoy doing to relax? Please list any special qualifications you have that will be current through this coming August (WSI, CPR, Lifeguard...) Please list any special skills or hobbies you have which might add to the camp expeience (guitar, dance, photography, art...) Is there anything else we should know about you? In addition to CPR/First Aid, we often train some of our staff to be lifeguards. How would you feel about that? I'd love toI'd be open toI'd be nervous about thatI don't know how to swimI'm already a certified lifeguard While there are many factors that go into matching staff with camps, what ages/grade levels do you prefer to work with ? Check ALL that apply K-12nd-3rd grade4th grade and older Harassment The camp's policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment. Have you ever been accused of harassment of any person including, but not limited to, workplace harassment? (Note: a prior accusation or conviction is not an automatic bar to employment. The type of conviction or accusation and when it occurred will be evaluated by the camp before any decision is made.) Harrassment YesNo Criminal Record Have you ever been convicted of a violent crime, a crime against children or any other crime other than a minor traffic offense? If yes, please describe. (Note: We do not request information about those convictions which have been sealed, or expunged, or statutorily eradicated. A prior conviction is not an automatic bar to employment. The type of conviction and when it occurred will be evaluated by the camp before any decision is made.) Criminal Record YesNo Authorization to Invest I authorize investigation of all statements herein, including any checks of criminal records, and release the camp and all others from liability in connection with same. I understand that, if employed, I will be an at-will employee unless there is an agreement or law which alters that status. Furthermore, I understand that any agreement must be in writing and signed by the designated camp official. I also understand that untrue, misleading, or omitted information herein or in other documents completed by the applicant may result in dismissal, regardless of the time of discovery by the camp. E-mail Phone Number Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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