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Date of Availability

From

(choose earliest possible date)

Position Applying For

Camp Counselor

Personal Information (where applicable, provide information as it is displayed on your passport)

Gender

Male Female

Family Name

First Name

Middle Name

Street Name

Home Number

Apartment Number

City

Country

Postal Code

Nationality

City of Birth

Country of Birth

Citizen Of

Resident Of

Home Phone
(include Country Code)

Fax Number
(include Country Code)

Cellular Phone
(include Country Code)

Other Phone
(include Country Code)

Email Address

Date of Birth

Height

Weight

Emergency Contact Information

Contact Name

Relationship

Phone Number
(include Country Code)

Alt. Phone Number
(include Country Code)

Travel Documents

Passport Number

Valid Until

Country Issuing Passport

Do you have an American Passport?

Yes No

Valid Until

Do you have a B1-B2 (Tourist) Visa?

Yes No

Valid Until

Has a request for an American visa ever been refused?

Yes (if yes give reason)
No

Has an American visa ever been cancelled?

Yes (if yes give reason)
No

Is there anything that would prevent you from getting an American visa?

Yes (if yes give reason)
No

Education

Are you currently a student in university? Yes No If yes:

University Name

City

Country

Year of Study

Major Studied

Personal Preferences / Details

Do you smoke?

Yes No

Consume Alcohol?

Yes No

Visible tattos or piercings?

Yes No

Do you use drugs?

Yes No

Full Driving License?

Yes No

Type of license

License Number

Valid until

Camp & Work Related Questions

Outdoor Experience

Yes No

How many years?

Worked with children?

Yes No

Age Group

6 - 8
9 - 12
13 - 16

First Aid Training

Yes No

In my opinion, the most important qualities of an applicant are:
(Write 3-5 sentences that you feel best answers the question)

Camp & Work Related Skills - Camp Counselor

What skills are in demand?

Water Front

Skill Level

Land Sports

Skill Level

Pioneering

Skill Level

Arts/Crafts/Dance

Skill Level

Additional Interests

Skill Level

Others

Skill Level

List 3 of your strongest skills from the list above. Include as many details as possible (how experience was gained, how many years of experience, etc.)
Please indicate experience with children.

Box used to describe a skill not in the dropdown
Box used to describe a skill not in the dropdown
Box used to describe a skill not in the dropdown

Why do you wish to participate in this program?

Please give a brief description of your background which would assist the camp director in making a positive decision in your favor. (Include Education, Social, Army or National Service)

Health Statement

Do you have any physical condition / illness which may affect your performance?

Yes No

Are you taking any medications or pills or undergoing medical treatment?

Yes No

Have you ever had a nervous breakdown or received psychiatric treatment?

Yes No

Do you have any allergies?

Yes No

Do you require a kosher diet?

Yes No

Do you require a vegetarian diet?

Yes No

Do you have any other special dietary restrictions or requirements?

Yes No

Do you have any previous criminal convictions or have you ever been accused of child abuse?

Yes No

If you answered “Yes” to any of the above, please provide details:

As a camp counselor or support staff worker, you will be amongst many nationalities. You will be a representative of your country and AICE at all times. You realize that camp is for the children and you will be called upon to devote yourself to the children and the camps needs. The hours may be very long and the pressures extreme. Can you accept curfews, very little free time (if any) and no privacy whatever?

Yes No

Application Terms and Conditions

In applying for a position, the applicant understands that there is a procedure to follow and that certain conditions and requirements need to be met. For the personal interview, the applicant needs:

To forward a completed application form via the web
3 letters of reference from persons other than friends or close family
Registration fee
4 passport photographs (with huge smile)
Student card (if applicable)
Army release documents (if applicable)
Copy of driving license (if applicable)
Passport (if available)

An interview cannot take place without provision of all the above.

Furthermore, the applicant agrees to the following

Placement takes into consideration many parameters and the company will endeavor to find the best possible placement on behalf of the participant, therefore the applicant cannot demand to be placed at a particular location except on religious grounds.
The company does not “place” applicants. A camp or location will accept an applicant based on details available. The company will take into consideration requests from friends however, is unable to guarantee placement of friends together or accept this request as a prior condition.
A camp or location will accept an applicant based on information provided however, there are times that an applicant may not have the necessary skills for a particular activity or, the applicant may need to be moved to another activity for other reasons, therefore the applicant cannot demand to work in a particular activity.
Many applicants find that they receive placement within weeks of being accepted on the program. However, sometimes the placement time may extend for several months. This is not because an applicant is not suitable. Camps and locations do have a schedule of their own and recruitment of staff may be later rather than earlier. Placement time can be immediate or be as late as June.
An applicant may be called upon to indulge periodically in activities other than what may be stipulated in a prior signed agreement. You will be part of a team and team spirit is very much part of every camp and location. Therefore, you may be expected to assist in activities other than what you originally expected. This is all part of being in a team.
Normally an applicant will meet and make many new friends. Plans made prior to travel to America do change. Please take into consideration that American camps do not provide return transportation to New York or JFK.
The camp or location has many needs and diligently and methodically fills these needs prior to the beginning of the season. Sometimes this takes time and sometimes, changes occur after placement has taken place. The applicant needs to understand that this may happen and that placement is at the sole discretion of the director or employer and in accordance with their needs.
A passport photograph as supplied by the applicant will be used on the web in order to assist in facilitating placement. A photograph is an integral part of the application. The photograph will assist in obtaining a placement. It is strongly advised the applicant provides a colored passport photograph WITH A HUGE SMILE. Your personality is just as important as your experience and your photograph is part of your presentation.

The above terms and conditions are for the benefit of all applicants and allow the company to expedite placement with the least amount of delay.

By submitting this application I declare the above information to be true. I understand that based on the information provided, I may be allowed to participate in the cultural exchange program.

I further understand that I am responsible for submitting a current passport photograph of myself which will be viewed by authorized recruitment personnel via the Internet web site (will not be accessible without AICE authorization). I agree to allow AICE to display my photograph for the purposes of obtaining placement on my behalf and/or for advertising and marketing purposes.

I have read all the above terms and conditions and agree to abide by them:

Yes No

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