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Summer Counselor Position

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Name, Phone Number, and Email

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Date of Birth/Age

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Have you had any experience working with children?

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What would you say is your strongest trait as an employable individual?

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Do you have a history of drug use or any other criminal activity?

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If so, please explain. (Community Service, Probation, etc.) If no, type: N/A

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Do you have a reliable mode of transportation?

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Why are you interested in this position?