Summer Discovery Camp
2012 Junior Counselor Application
(Please print and mail to Lisa Bates, Camp Director, EcoTarium, 222 Harrington Way,
Worcester, MA 01604, 508-929-2756 by March 15st, 2012.) Applications received after
deadline will not be honored.
Name: _________________________
Date of Birth:____________________
Address:________________________
School:_________________________
_______________________________
Grade (Fall 2012):_______
Parent/Guardian:__________________
Home phone:(____) ______-________
Home email:______________________
Junior Counselor training days are June 28th (9am-5pm) and June 29th (9am-1pm).
Attendance on both days is mandatory for all JCs. Those unable to attend will not be
admitted to the program. Exceptions will be made only in the case of conflict with your
regular school calendar.
Indicate which two sessions you are in interested in applying for (You may choose more than
one, but you must commit to two sessions, not including training dates).
_____Session
_____Session
_____Session
_____Session
_____Session
1
2
3
4
5
July 2nd -6th, How Things Work
July 9th-13th, EcoTarium Adventure
July 16th -27th, Amazing Animals (2 week camp)
July 30th–August 3rd, EcoTarium Adventure
August 6th -10th, How Things Work
Please write a brief, mandatory, statement on a separate sheet of paper explaining
your interest in the Junior Counselor position at the EcoTarium. Include thoughts such as
what you can add to the camp community as well as what you hope to gain. Past camp
experience and future goals should be mentioned here. Incomplete applications will not be
considered.
Applicant Signature: ___________________________
Applicant Printed name: ________________________
Date: ______________________
Parent/Guardian Signature: _____________________ Date: ______________________
Parent/Guardian Printed name: ___________________
*Medical forms and permission forms are available online at www.ecotarium.org/camp and must be submitted
upon acceptance or before May 31st.