Moshava JCUSA Application Form - Jewish Camps USA

Jewish Camps USA

info@jewishcampsusa.com

0272 642 058
israel@jewishcampsusa.com

+54 911 6940 8647
latam@jewishcampsusa.com

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Moshava JCUSA Application Form

"*" indicates required fields

Step 1 of 5

20%

Personal Details

Name*

First Last

Gender*

Gender*

Nationality*

First Language*

Please enter your first language here.

Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code 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?*

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?*

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*

Skill 2: Please select another area which you must have experience in and/or a qualification*

Skill 3: Please select another speciality area which you must have experience in and/or a qualification*

Skill 4: Please select another speciality area which you must have experience in and/or a qualification*

Skill 4*

As you selected other, please type your chosen skill.

Qualifications

Have you got any non-educational qualifications?*

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?*

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?*

Please give full details*

Do you suffer from any pre-existing medical conditions?*

Please give full details*

Have you ever had any emotional and/or psychological difficulties?*

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*

Are you still seeking professional help?*

When did you stop receiving professional help?*

Please state the month and year.

Did you receive medication?*

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?*

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)?*

Are you vaccinated against MMR (Mumps, Measles, Rubella)?*

Are you vaccinated against Polio?*

Health Background

Do you smoke and/or vape?*

Do you have any allergies?*

What allergies do you have?*

Do you have any dietary requirements?*

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?*

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?*

This does not include a tourist visa.

What type of visa did you have?*

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

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?*

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.*

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

Δ

Jewish Camps USA offer work opportunities at Jewish summer camps in the USA.
Apply to work as a summer camp counsellor in the USA and experience the best of American culture.

Jewish Camps USA Ltd.
Company registration number 11125638

The Old Kiln House, 15 – 17 High St, Elstree, Borehamwood WD6 3BY, United Kingdom

0203 972 2911

© 2022 Jewish Camps USA . All Rights Reserved. Legal Info | Private Notice | Cookie Policy

אנחנו ארגון המציע הזדמנויות למאות מועמדים לחוות מחנה קיץ בצפון אמריקה (ארה”ב וקנדה). הגישו מועמדות עכשיו כדי להתחיל את המסע שלכם ולעבוד במחנה קיץ בצפון אמריקה.

Jewish Camps USA Ltd
HaMasger St 39, Tel Aviv-Yafo, 6721409
0272 642 058

© 2022 Jewish Camps USA . All Rights Reserved. Legal Info | Private Notice | Cookie Policy

Jewish Camps USA ofrece oportunidades de trabajo en Campamentos de Verano en Estados Unidos.
Aplicá para trabajar como Counselor en un Camp de Verano de Estados Unidos y tene la mejor experiencia de tu vida.

Jewish Camps USA Ltd.

+54 911 6940 8647

© 2022 Jewish Camps USA . All Rights Reserved. Legal Info | Private Notice | Cookie Policy