Jewish Camps USA
info@jewishcampsusa.com
0272 642 058
israel@jewishcampsusa.com
+54 911 6940 8647
latam@jewishcampsusa.com
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Aplicando a Jewish Camps USA
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Moshava JCUSA Application Form
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Personal Details
Name
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First
Last
Gender
*
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Female
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Gender
*
Nationality
*
First Language
*
Please enter your first language here.
Address
*
Street Address
Address Line 2
City
County / State / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
City of Birth
*
Phone number
*
Please start your phone number with a + and do not put any spaces.
Email
*
Enter Email
Confirm Email
Date of Birth
*
DD slash MM slash YYYY
Picture
*
Accepted file types: jpg, jpeg, png, gif, Max. file size: 64 MB.
Smile, your camp director will see this!
How many years will you have worked at camp including this summer?
*
If summer 2023 is your first summer at this camp, put 1.
Is your passport in date until at least February 2024?
*
Yes
No
If your passport expires before
February 2024
then please apply for a new passport as soon as possible.
Do you have a valid US passport?
*
No
Yes
Emergency Contact Details
Name
*
First
Last
Relationship to you?
*
Phone number
*
Email
*
Enter Email
Confirm Email
Education / Work
Are you currently studying at University/College?
*
Yes
No
What University/College are you studying at?
*
What are you studying?
*
Are you currently employed?
*
Yes
No
Who is your employer?
*
What is your job title?
*
Skills
Please list your skills in order of experience with number 1 being your most experienced and number 4 being your least.
Skill 1: Please select your main speciality area which you must have experience in and/or a qualification
*
High/Low Ropes
Rock/Wall Climbing
Archery
Arts & Crafts
Arts & Crafts - Batiking
Arts & Crafts - Ceramics/Pottery
Arts & Crafts - Jewelry Making
Woodwork
Mountain Biking
Board Games
Team Sports
Individual Sports
Racket Sports
Gaming
Fitness
Yoga
Pilates
Gymnastics
Trampolining
Cheerleading
Aerobics Instructor
Martial Arts
Outdoor Adventure Skills
Nature
Outdoor Camping
Outdoor Cooking
Hiking/Trekking
Garden work
Horse Back Riding
Farm Animal Care
Nature
Cooking
Dancing
Drama
Song Leader
Theater/Stage Manager
Music
Digital Media
Photography
Film Photography
Video Production
Radio/TV/Broadcasting
Camp Counselor
Special Educational Needs Teaching/Experience
Welfare/Social Work
Israeli Culture
Israeli Scouts
Doctor/Medic
Astronomy
Lifeguard (Certified)
Lifeguard (Non-certified)
Swimming Teacher
Water Sports (Canoeing, Boat Driving, Kayaking, Sailing)
Fishing
Skill 2: Please select another area which you must have experience in and/or a qualification
*
High/Low Ropes
Rock/Wall Climbing
Archery
Arts & Crafts
Arts & Crafts - Batiking
Arts & Crafts - Ceramics/Pottery
Arts & Crafts - Jewelry Making
Woodwork
Mountain Biking
Board Games
Team Sports
Individual Sports
Racket Sports
Gaming
Fitness
Yoga
Pilates
Gymnastics
Trampolining
Cheerleading
Aerobics Instructor
Martial Arts
Outdoor Adventure Skills
Outdoor Camping
Outdoor Cooking
Hiking/Trekking
Horse Back Riding
Farm Animal Care
Garden work
Nature
Animals
Cooking
Dancing
Drama
Song Leader
Theater/Stage Manager
Music
Digital Media
Photography
Film Photography
Video Production
Radio/TV/Broadcasting
Camp Counselor
Special Educational Needs Teaching/Experience
Welfare/Social Work
Israeli Culture
Israeli Scouts
Doctor/Medic
Astronomy
Lifeguard (Certified)
Lifeguard (Non-certified)
Swimming Teacher
Water Sports (Canoeing, Boat Driving, Kayaking, Sailing)
Fishing
Skill 3: Please select another speciality area which you must have experience in and/or a qualification
*
High/Low Ropes
Rock/Wall Climbing
Archery
Arts & Crafts
Arts & Crafts - Batiking
Arts & Crafts - Ceramics/Pottery
Arts & Crafts - Jewelry Making
Woodwork
Mountain Biking
Board Games
Team Sports
Individual Sports
Racket Sports
Gaming
Fitness
Yoga
Pilates
Gymnastics
Trampolining
Cheerleading
Aerobics Instructor
Martial Arts
Outdoor Adventure Skills
Outdoor Camping
Outdoor Cooking
Hiking/Trekking
Horse Back Riding
Farm Animal Care
Garden work
Nature
Animals
Cooking
Dancing
Drama
Song Leader
Theater/Stage Manager
Music
Digital Media
Photography
Film Photography
Video Production
Radio/TV/Broadcasting
Child Care (Babysitting/Nanny)
Special Educational Needs Teaching/Experience
Welfare/Social Work
Israeli Culture
Israeli Scouts
Doctor/Medic
Astronomy
Lifeguard (Certified)
Lifeguard (Non-certified)
Swimming Teacher
Water Sports (Canoeing, Boat Driving, Kayaking, Sailing)
Fishing
Skill 4: Please select another speciality area which you must have experience in and/or a qualification
*
High/Low Ropes
Rock/Wall Climbing
Archery
Arts & Crafts
Arts & Crafts - Batiking
Arts & Crafts - Ceramics/Pottery
Arts & Crafts - Jewelry Making
Woodwork
Mountain Biking
Board Games
Team Sports
Individual Sports
Racket Sports
Gaming
Fitness
Yoga
Pilates
Gymnastics
Trampolining
Cheerleading
Aerobics Instructor
Martial Arts
Outdoor Adventure Skills
Outdoor Camping
Outdoor Cooking
Hiking/Trekking
Horse Back Riding
Farm Animal Care
Garden work
Nature
Animals
Cooking
Dancing
Drama
Song Leader
Theater/Stage Manager
Music
Digital Media
Photography
Film Photography
Video Production
Radio/TV/Broadcasting
Child Care (Babysitting/Nanny)
Special Educational Needs Teaching/Experience
Welfare/Social Work
Israeli Culture
Israeli Scouts
Doctor/Medic
Astronomy
Lifeguard (Certified)
Lifeguard (Non-certified)
Swimming Teacher
Water Sports (Canoeing, Boat Driving, Kayaking, Sailing)
Fishing
Other
Skill 4
*
As you selected other, please type your chosen skill.
Qualifications
Have you got any non-educational qualifications?
*
Yes
No
If so, what qualification(s)?
*
For example: Horseback riding, singer, boat driver, lifeguard, first aid, sports qualifications, archery, ropes, rowing etc...
Medical History
Please note the information you provide here is confidential and we will only speak to you further about your answers if we believe it is in the best interest of you and your camp experience.
Are you currently on any prescription medication?
*
No
Yes
If this situation changes, you must make us aware. Please do not include contraceptive pill for this.
Please provide a list of all of your current medications.
*
This should include all of your prescription medications. Please include the name, dosage and the reason that you are taking it.
Are you in good physical health?
*
Yes
No
Please give full details
*
Do you suffer from any pre-existing medical conditions?
*
No
Yes
Please give full details
*
Have you ever had any emotional and/or psychological difficulties?
*
No
Yes
This includes depression, anxiety, nervous breakdown, drug addiction, eating disorder, and any other emotional or psychological difficulties.
Please give full details
*
Did you seek professional help? e.g. therapy, counselling
*
Yes
No
Are you still seeking professional help?
*
Yes
No
When did you stop receiving professional help?
*
Please state the month and year.
Did you receive medication?
*
Yes
No
Please give full details
*
Immunisations
Please note, you will have to visit your healthcare professional and undertake a medical assessment as well as gain full records of the month and year of all of your immunisations, which you will have to provide to JCUSA and camp.
Are you fully and up-to-date with vaccinations against Covid-19?
*
Yes 2 Covid Vaccines
Yes 3 Covid Vaccines
Yes 4 Covid Vaccines
No
This does not include Sputnik and if you have had this vaccine then you must say "no".
Approved vaccines include (as approved by CDC):
Pfizer-BioNTech
Moderna
Johnson&Johnson
AstraZeneca
Covaxin
Covishield
BIBP/Sinopharm
Sinovac
Novavax/Covovax
If you have not been vaccinated with at least 2 vaccines listed above, you must state "no".
Which Covid vaccination(s) have you had?
*
Please put the brand(s) of vaccine you had here.
Are you vaccinated against DPT (Diphtheria, Pertussis, Tetanus)?
*
Yes
No
Are you vaccinated against MMR (Mumps, Measles, Rubella)?
*
Yes
No
Are you vaccinated against Polio?
*
Yes
No
Health Background
Do you smoke and/or vape?
*
No
Yes
Do you have any allergies?
*
No
Yes
What allergies do you have?
*
Do you have any dietary requirements?
*
Yes
No
What are your dietary requirements?
*
Kosher
Vegan
Vegetarian
Pescatarian
Gluten Free
Dairy Free
Other dietary restrictions
In full details please describe your dietary requirements.
*
Background Check
Do you have any criminal convictions or cautions?
*
No
Yes
It is extremely important that you are open and honest with your answer as not telling the truth can result in extra fees. If you answer yes, JCUSA will review this on a case by case basis and will contact you.
Every JCUSA staff member must have an up to date background check processed.
Please give details.
*
Including date and offence.
Previous Visa Details
Have you had a visa in the past?
*
No
Yes
This does not include a tourist visa.
What type of visa did you have?
*
J1 Camp Counsellor Visa
Other
Please give details of the visa.
*
Please include the type of visa, location it was for and year it was issued.
If you have multiple, please list them all.
Please write here what year the J1 visa was for and who the visa sponsor was.
*
If you have multiple, please list them all.
E.g. 2017 - Jewish Camps USA, 2018 - Jewish Camps USA
Please upload a copy/copies of your previous J1 visa (as in your passport).
Drop files here or
Select files
Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 64 MB.
You can multi-upload if needed.
Have you ever been rejected a visa?
*
No
Yes
Please give details.
*
Please include the name of the visa, location, year and reason you were rejected.
Data Protection
Jewish Camps USA may pass my personal details on to other people within the process such as interviewers and camp directors.
*
Yes
No
Any information that we pass on will be done so safely and securely.
Jewish Camps USA may send me information which may interest me via email?
*
Yes
No
I understand that I need to pay $160 to JCUSA if I decide to leave camp early, or get asked to leave my job before my contract ends.
*
Yes
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