P.O. Box 287 Fort Washington, PA 19034
Email: summer@gacamp.org
Phone: 267.405.7321
Fax: 267.405.7184
Date of Application_____________________ Name___________________________________________ Date of Birth _________________ Permanent Address ____________________________________________________________ Street & Number
City
State
Zip
Second Address ________________________________________________________________ Street & Number
City
Phone_____________________________
State
Zip
Cell Number___________________________
Area Code & Number
E-mail____________________________________ Fax _______________________________ All Communication is done through E-mail
1st position or camp you are applying for: ____________________________________________ 2nd position or camp you are applying for: ____________________________________________ Have you graduated from High School?
Yes
No
If “NO” what grade are you in as of the date of this application?
please circle
Have you graduated from College?
Yes
No
9
10 11 12
please circle
College students: What year are you in as of the date of this application?
please circle
1
2
3
4
please circle
Work or Volunteer Experience – List any experience associated with working with children ages 3-18 Dates From ____________ To
Employer/Organization
Position
_________________________
________ From ____________ To
________ Education Year
School
Achievements
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Supervisor’s Name & Phone Number