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 r[email protected] Full Name First Name Last Name M/F MaleFemale Social Security Number Parent's Name First Name Last Name Home 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 Date of Birth Phone Number Area Code Phone Number Parent's Number Area Code Phone Number E-mail Dates Available What type of position are you interested in? Where did you hear about CGI Manalapan? Past Camp Work History - Provide a record of all relevant employment (paid and volunteer). Include position, supervisor/head counselor and their contact info.. Work History 1 Year City & Head Counselor/Director Your Position Phone & Email Work History 2 Year City & Head Counselor/Director Your Position Phone & Email Work History 3 Year City & Head Counselor/Director Your Position Phone & Email Other Work or Volunteer Experience Character References - Give names and contact info. of three persons (2 non-relatives) having knowledge of your character, experience, work habits and ability. Character Reference 1* Name Phone Nember Address Capacity in Which They Know You Character Reference 2* Name Phone Nember Address Capacity in Which They Know You Character Reference 3* Name Phone Nember Address Capacity in Which They Know You Education - Please List High School and Seminary/College Education, and References: names and contact info School Reference* Year/s School/Seminary Reference Name Phone/Email School Reference Year/s School/Seminary Reference Name Phone/Email Current Grade 10th Grade11th Grade12th GradeCollege/Sem AlephCollege/Sem Bet+ WSI, Lifeguard, CPR/1st Aid Certification I am certified in CPR/1st Aid through the end of August of this year.I am not CPR/1st Aid certified, and will arrange for my own trainingI am certified in WSI through the end of August of this year.I have Lifeguard Certification through the end of August of this year. What special contributions do you think you can make at Camp Gan Israel? 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.) Harassment * YesNo Explain: Criminal Record - Have you ever been convicted of a violent crime, a crime against children or any other crime, including sex-related or child-abuse related offenses 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* YesNo Explain: Have you had any serious illness?* YesNo Have you had any mental heath illness?* YesNo Are you on any medication?* YesNo Explain: Authorization to Investigate 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. 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