Camp Staff Application

Counselor Job Description

* indicates a required field 
Staff Information
*Name:  First    Middle   Last
*Address :  
*City:        State      Zip
*Phone:      Email
*Sex:   Male       Female      Prefer to self-describe
*Date of Birth:  (mm/dd/yyyyy)
*Birth Country:  
*Are you:   International Adoptee       Domestic Adoptee
*Adoption Agency:   Holt-USA       Other
*I will be 18 years or older & a high school graduate at the time of camp: Yes       No
Prior Work Experience
Dates Employer/Supervisor Address Responsibilities Phone/Email
Certifications( Health/Safety)
Please mark those for which you hold current certification:
CPR       Lifeguard       First aid       Nursing       Other
Please answer the following questions
*How did you hear about Holt Camp?
*Why do you want to be a part of Holt Camp?
Cover Letter:




Holt International is a registered 501(c)3 nonprofit organization. All donations are tax deductible to the full extent of the law. EIN: 23-7257390.