Counselor Application

Counselor Application
goto the printable version

Name
Street Address
City
State
Zip/Postal Code
Home Phone	Cel Phone
Email
Summer Address (if different)

Parent's Home (if different)
Shoe size		Shirt Size	Age Sex
High School attended
College
Year in school		Major

School Activities (Athletics, Clubs, Positions):

Certifications (CPR, Lifesaving, WSI, EMT, Eagle Scout, Gold Star):

Hobbies Interests:

Camps Attended:

Running PR's and Accomplishments:

References (teachers, coaches, community, religious, etc.):
Name:
Occupation:
Phone Number:

Name:
Occupation:
Phone Number:

Name:
Occupation:
Phone Number:

Camps Avaliable for:

Lake Tahoe
July 27-Aug.1, 2008

Malibu (Cottontail Ranch)
Aug 3-8, 2008

Idyllwild
August 10-15, 2008

Staff Pay: $300.00* for 1st and 2nd year Runner's Workshop staff, $325.00 for 3rd/4th year staff, $350.00 for 5 + years staff. *Plus Room and Board and ASICS gear. $50.00 bonus for certified lifeguards.
Comments:

Please print this form and mail to Runner's Workshop, P.O. Box 5028, Los Alamitos, Ca. 90720

Runner's Workshop P.O Box 5028 Los Alamitos CA, 90720
Phone: (562) 493-7545 Fax: (562) 431-5207 E-Mail Runner's Workshop