I Would Like to Apply to be a Counselor for the trip in: *

July

August

Either I have no preference

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date-of-Birth *

MM

DD

YYYY

Have you attended any traveling camps? *

Yes

No

Reference #1 *

First Name

Last Name

Phone # *

(###)

###

####

Reference #2 *

First Name

Last Name

Phone # *

(###)

###

####

Are you applying with any friends? *

Yes

No