Lansman's Day Camp, Where Memories Are Made

Staff Application Form

Applicant Information
Last Name
Date of Birth        
T-Shirt Size
Mailing Address
City State:  Zip: 
My Home Address is different from my Mailing Address above.
Email Address:
Contact Phone:
Social Security Number
Country of Citizenship
High School Attended
Year of Graduation
What are your plans for fall?
Graduation Year
How did you hear about Lansman's Day Camp?
What are two activities you would like to teach your campers this summer?
Work Experience
  Organization Years Position Salary Address
Have you attended camp before as a camper? if so, please list camps and dates.
  Name Title Phone
What are your main reasons for choosing to work at camp?
Any other experience with children?
Do you hold any Red Cross certificates?


Please Specify:
Do you have a valid driver’s license?


Have you ever been convicted of child abuse?


Please indicate your experience in the following activities:
Activity Well Qualified / Have Taught Some Experience Little or No Experience
Athletics  Aerobics
 Ga Ga
Water Sports  Lifeguard
Outdoor Life  Hiking
Creative Arts  Ceramics
Performing Arts  Drama
Additional skills or activities you can offer at camp:
Which age group would you prefer to work with?
I certify that all statements in this application are true and complete. In addition I give Lansman’s Day Camp approval to conduct any criminal or background checks they deem appropriate or necessary. I authorize my likeness in any promotional material (print, video, electronic) for Lansman’s Day Camp.

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Lansman's Day Camp Winter Address 40 Amherst Pl. Livingston, NJ 07039
Phone: (845) 434-8480      Fax: (845) 468-7025
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