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Counselor Application
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• Our Pillars • Engman Camp Shalom •
Counselor Application

ECS Counselor Application

Thank you for your interest in working with Engman Camp Shalom. Please fill out the form below.

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URL

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Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Mobile Phone*

Email*

Date of Birth*

Month

Day

Year

Grade For Incoming School Year*

T-shirt Size*

Emergency Contact Name*

First Last

Emergency Contact Phone Number*

Who is your primary care physician? Please list name and phone number*

Do you have any allergies or medical conditions?*

No

Yes

Please explain

Date of last physical*

Month

Day

Year

Date of last Tetanus Immunization*

Month

Day

Year

Which weeks are you available to work at Engman Camp Shalom?*

Week 1 (June 7-11)

Week 2 (June 14-18)

Week 3 (June 21-25)

Week 4 (June 28-July 2)

Week 5 (July 6-9)

Week 6 (July 12-16)

Week 7 (July 19-23)

Week 8 (July 26-30)

Week 9 (August 2-6)

Week 10 (August 9-13)

Week 11 (August 16-20)

What makes you want to be a camp counselor at ECS?*

What qualifications do you have that make you suitable for this position?*

Did you attend summer camp as a child? What did you like/dislike about it?*

What age groups do you have experience working with? Which age group do you prefer to work with?*

How do you handle stressful situations? Please provide an example.*

Are you a team player? Please explain.*

Why did you choose to apply for our camp and not another one?*

Are you capable of following a detailed daily schedule for camp days? If not, why?

What activities (arts and crafts, science, sports, etc) do you like to lead?*

When it comes to communication with coworkers and the camp director, which forms work best for you?

If your application is accepted, can you commit to a follow up phone and in person interview?

Reference 1 Name*

First Last

Reference 1 Phone Number*

Reference 1 Email*

Reference 2 Name*

First Last

Reference 2 Phone Number*

Reference 2 Email*

Our Pillars

Gan Shalom Preschool
Beit Sefer Shalom
Engman Camp Shalom
Jewish Community Relations Council
Iowa Jewish Historical Society
Jewish Family Services
Iowa Holocaust Memorial
Partnership2Gether

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Jewish Federation of Greater Des Moines

Working to enrich Jewish living through connection, education and compassion

33158 Ute Ave.
Waukee, IA 50263
Phone: 515-987-0899
info@jewishdesmoines.org

Charity ID Number: 42-0835321

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