Complete the application below and someone will get back to you. All fields are required unless otherwise stated. NameAgeDate of BirthAddressCityStateZipEmailT-Shirt Size—Please choose an option—Youth SYouth MYouth LAdult SAdult MAdult LAdult XLApplying ForWhole SummerFirst HalfSecond HalfPosition DesiredCounselorJunior CounselorLifeguardLearning RebbeJunior AssistantArts & Crafts/WoodworkingWhich age group do you prefer?Grades 1-2Grades 3-5Grades 6-9Phone NumbersHomeBest Time to reachCellBest Time to reachYeshivaBest Time to reachYESHIVAHS ATTENDEDNowGradeLast YearGradeTwo Years AgoGradeRebbiPhoneMenahelPhoneCAMP EXPERIENCE (if any)Name of CampPositionYear AttendedReferencePhoneName of CampPositionYear AttendedReferencePhoneYour SkillsPlease check any of the following attributes that you could share with us as a staff member at Camp Merockdim: BaseballTeach SongsSwimmingArts & CraftsWrite playsOvernight hikingWoodworkingAct in playsFunBasketballVolleyballMusical instrumentOtherIf Other ReferencesReference 1Relationship to youPhoneReference 2Relationship to youPhoneΔ