Camp Hiawatha Counselor-in-Training Application

Applicant Information

Full Name

Date of Birth

Email Address

Phone Number

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Current School

Parent/Guardian Information

Parent/Guardian Name(s)

Email Address

Phone Number

Emergency Contact (if different)

Camp Experience

Have you previously attended Camp at The Greater Wichita YMCA?

Yes

If yes, list years attended and programs participated in:

Have you participated in other leadership/school programs? If so, please explain:

Short Answer Questions

Why are you interested in becoming a Counselor-in-Training at Camp Hiawatha?

What does being a leader mean to you?

Describe a time you helped someone or served your community. What did you learn from that experience?

What is one skill you would like to grow or improve during this program?

Availability & Commitment

What secession interests you most?

Secession 1

Secession 2

Both

Weeks unavailable (if any)

Why is commitment important in a leadership role?

References

Please provide two references who can speak to your character, responsibility, and leadership potential (1 personal and 1 professional such as a teacher).

Reference #1

Name

Relationship to applicant

Phone number

Email address

Reference #2

Name

Relationship to applicant

Phone number

Email address

Applicant Agreement

I understand that the Counselor-in-Training program is a leadership development opportunity and not a paid position. I agree to follow all camp rules, demonstrate positive behavior, and serve as a role model to campers and peers.

Applicant signature

Sign above

Date

Parent/Guardian signature