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On-Site Director Application

On-Site Director Application


Last Name
First Name
Hebrew Name
Mother's Hebrew Name
Date of Birth
Born after Sunset
Yes No
Hebrew Birth Date
 Home Address
Home phone
Cell phone
Social Security
USA Other - 
Completed 12th Grade
Completed Seminary 1
Name of Seminary attending/attended
Are you First Aid certified?
Yes No
If yes, when does it expire? (If yes, Send the form by email to
Are you CPR certified?
Yes No
If yes, when does it expire? (If yes, Send the form by email to  
Please list any specific allergies: 
Do you have a driver’s license?
Yes No 
If yes, how many years have you been driving?
Do you feel comfortable with having the responsibility of driving the counselors? Yes No 
Driving a mini-van? Yes No 
Do you have experience and feel comfortable driving on highways? Yes No 
Have you worked with children before? Yes No
List 3 adults for whom you’ve worked within the past 2 years, in a summer camp, Hebrew school or Junior Congregation. List your position and a contact phone number as a reference:
Company Name
Name of Reference & Contact Number
Company Name
Name of Reference & Contact Number
Company Name
Name of Reference & Contact Number

Reference Name
Relationship to Applicant
Reference Name
Relationship to Applicant

Emergency Contact Information
Contact 1
Relationship to Applicant
Are there any medical concerns that we should be aware of?
Contact 2
Relationship to Applicant
Parent's Daytime Phone
Parent's Daytime Phone
Parent's Daytime Phone
Please list any specific dietary kashrus requirements: shechita, milchig, etc…
Family Physician

Please choose and number according to preference:
Mark areas in which you are talented:



Camp Spirit








Do you play an instrument? Yes No  If yes which one?
Would you like to be the coordinator of extra-curricular activities for the staff? Yes No

Tee Shirts
You will be required to wear a camp T-shirt every camp day. Please select your t-shirt size. T-shirts can shrink and tend to run small. When in doubt, order the next size.
SIZE:  Small Medium Large Extra Large

Camp runs from 9am –4:00pm (3:00pm Fridays), from June 29th to July 31st, 2017.
I understand that Camp runs from June 29th to July 31st, 2017, and registration to be an on-site director is for the full session only. 

I will arrive and fully available for pre-camp training up to a week before camp begins and will remain until 1 week after camp ends, after noon. That means I will arrive on June 22nd and will depart on August 7th.

As every one of our staff members is a Shlucha and represents the Rebbe in everything she does, staff dress code must be one that befits such status. Standards of Tznius for our staff include but are not limited to: A) long length skirts that cover the knees at all times with no slits at all. B) leg coverings no shorter than knee socks. C) sleeves that cover the elbows at all times. D) necklines that cover “the bone” at all times D) long sleeve camp t-shirt in camp every day. This is very important to us and not “negotiable”. These standards apply throughout the duration of a counselor’s stay in Riverdale, NOT only during camp hours.
I understand that by signing this form I have applied in earnest to be a head staff member at Camp Gan Israel of Riverdale, and I can expect to hear a response from the camp director within 1 week from the application date. From the time I sign this application form I will not be available to be hired for the same dates elsewhere. By signing this form I am indicating that I am ready to be a head staff member at CGI Riverdale if I am accepted.
Signature   Date



Camp Updates
Summer 2017

June 29-July 31
Register your child today!
Upcoming Events
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