Staff Registration Personal InformationName(Required) First Last Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Last 4 Digits of SSN(Required)Please enter a number from 0001 to 9999.Date of Birth(Required) MM slash DD slash YYYY Age as of June 2025(Required)EducationYeshiva Attending(Required)Current Rebbe(Required)Rebbe's Phone NumberGrade Level in Upcoming School Year(Required)10th Grade11th Grade12th GradeBeis MedrashOtherReferencesReference 1 Name and Relationship(Required)Phone(Required)Reference 2 Name and RelationshipPhone(Required)Previous Summer ExperiencesPlease list the programs you attended during the previous two summers, including the name, address, and contact number for each.Name of Program #1(Required)Location (Full Address)(Required)Years Attended(Required)Job Description(Required)Contact (Phone, Email)(Required)Name of Program #2(Required)Location (Full Address)(Required)Years Attended(Required)Job Description(Required)Contact (Phone, Email)(Required)Additional InformationT-Shirt Size(Required)Please SelectSmallMediumLargeXLXXLAre you a Certified Lifeguard?(Required)Please SelectYesNoIf yes, when did you receive certification?(Required)Are you CPR certified?(Required)Please SelectYesNoPersonal StatementsWhy are you interested in working at Aliyah Sports Camp? (Minimum one paragraph)(Required)What skills and qualities do you believe you can contribute to Aliyah Sports Camp? (Minimum one paragraph)(Required)What are your talents and hobbies? (long answer)(Required)AuthorizationConsent(Required) I hereby authorize Aliyah Sports to conduct an investigation into my background and qualifications for the purpose of evaluating my suitability for the position for which I am applying. I understand that Aliyah Sports may utilize external agencies to assist in verifying such information, and I explicitly authorize such an investigation, including the use of information services and other entities chosen by the company.
