STAFF APPLICATION

If You Live In Israel, Click Here.

The items marked with an asterisk * are required.

Please note: To move from field to field press the TAB key.

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  • PERSONAL INFORMATION
*Last Name:
First Name:
Are you a US citizen?: yes no
Social Security:
If NOT a USA Citizen,
Country of Citizenship:
Home Address:
Number and Street:
City:
State:
Zip:
Country:
Telephone:
Cell-Phone:
*E-Mail:
If applicable:
School Attending Presently:
Grade presently in School (if in High School):
School Address:
No.and Street:
City:
State:
Zip:
Country:
School Telephone:
School E-Mail Address:
Male Female
Age:
Date of Birth:

Position Desired:
(ie. Counselor, Kitchen, Dining Hall, Sports, Lifeguard, Arts & Crafts, Gan (Staff Children Day Camp), Moreh, Camping, Canteen, Office, Infirmary, Ropes Course, Mountain Biking, Radio, Drama, Division Head)

First Choice:
Second Choice:
If counselor, indicate the age group you are most interested in working with (1st,2nd, 3rd choices)

(please write in your "first choice," "second choice" etc)
Grades 3,4:
Grade 5,6:
Grade 7,8:
Grade 9:
Are you interested in 8 week employment? yes no
If 4 week employment - Write in First or Second Session
Available from:
to:

  • BNEI AKIVA/MOSHAVA CAMP EXPERIENCE:

    • Did you attend Camp Moshava as a camper? yes no
    What years?
    Have you worked in Camp Moshava? yes no
    If yes, in which Moshava:
    Job Assignment - 1st Summer:
    Year: How many months:
    Job Assignment - 2nd Summer:
    Year: How many months:
    Job Assignment - 3rd Summer:
    Year: How many months:

  • EXPERIENCES AT OTHER CAMPS:

    • Camp Name & Location: Position (including as a camper): Director of Camp: Salary: Year:

  • EDUCATION

    • School of Study Name and Location of School Course No.of years completed Did you Graduate? Degree
    High School yes no
    College yes no
    Graduate Work yes no
    Special Training yes no

  • WORK EXPERIENCE:

    • #1
    Company Name:
    Location:
    Telephone Number:
    Name of Supervisor:
    Describe Your Work:
    Dates of employ:
    Pay:
    Reason For Leaving

    #2
    Company Name:
    Location:
    Telephone Number:
    Name of Supervisor:
    Describe Your Work:
    Dates of Employ:
    Pay:
    Reason For Leaving

    #3

    Company Name:
    Location:
    Telephone Number:
    Name of Supervisor:
    Describe Your Work:
    Dates of Employ
    Pay
    Reason For Leaving

  • GENERAL INFORMATION:

    • Have you been to Israel?: yes no
    What Years?:
    On What Programs:
    Do you read Hebrew?: yes no
    Write Hebrew?: yes no
    Speak Hebrew?: yes no
    Bnei Akiva Member?: yes no
    What Shevet?:
    Have you attended TVI: yes no
    (What year):
    Mach Hach B'Aretz?: yes no
    (What Year):
    (Rosh Bus:):
    Married: yes no
    List:
    Children's Names: Age: Sex:
    Were you ever convicted of any crime including sex and child abuse related offenses? yes no

  • REFERENCES (VERY IMPORTANT!):

    • Please list three persons (OTHER than friends or relatives) that we can contact for references:
    #1
    Name:
    Address:
    Telephone #:
    Relationship:
    Length of Relationship:
    #2
    Name:
    Address:
    Telephone #:
    Relationship:
    Length of Relationship:
    #3
    Name:
    Address:
    Telephone #:
    Relationship:
    Length of Relationship:

  • SPECIAL SKILLS/TALENTS

    • Please list and describe any special skills or talents that you have an ability to teach or in which you have had experience:

    Are you a certified lifeguard?
    Credentials and Expiration Dates:

    (Attach photocopies of current certificates to the application)

  • EMERGENCY INFORMATION:

    • Mother's Name:
    Father's Name:
    Spouse's Name:
    Mother's Work Number:
    Father's Work Number:
    Spouse's Work Number:

    In case of emergency and either of your parents, or spouse are not available, please notify:
    Name:
    Address:
    City,State,Zip:
    Telephone:
    Relationship:
    Hospital Insurance:
    Carrier and Number
    Major Medical Insurance:
    Carrier and Number

    Please write a statement the describes your thoughts on the following camp issues:

  • Why do you want to work at a summer camp?
  • Why do you want to work at Bnei Akiva/Camp Moshava?
  • What characteristics do you possess that will facilitate your functioning as an effective staff member?
  • Please elaborate on how you will benefit from the experience of working as a staff member at Camp Moshava?

    • Working at a Bnei Akiva Camp is a serious and demanding commitment. Your signature to this application indicates your willingness to give your best efforts to achieve Camp Moshava's purposes. Your signature also gives Camp Moshava permission to contact references and to do a criminal background check.

    Submitting the form allows us to contact references and do a background check.

     


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