Bringing Magic to families coping with cancer.
New Counselor Application 2013
In addition to your application if you feel that your resume, or any other relevant
information, would accurately or clearly illustrate your qualification, please feel
free to attach them to the application.
Please bring your completed application to Hillel at Stanford, located at 565
Mayfield Avenue on the corner of Campus Drive and Mayfield by Friday,
February 1st at 5 PM.
Alternatively, please email your application to our Counselor Coordinators, Emily
Mann and Ben McKenzie at counselor@campkesemstanford.org with the subject line
“Your Name – Kesem Application”
A. Personal Information
_____________________________________________________________
Last Name
First Name
Middle Initial
_______________
Date of Birth
______
Age
__________________________
Major
Sex: M
F
___________________________
Year in School
_________________ ___________________
Cell Phone Number
Current Email
______
__________
Permanent Email (if different)
_________________________________________________
Residence
Room Number
B. Experience and Skills
Please briefly describe your relevant experience working with children, if any.
Please briefly describe your relevant past camp experience, if any.
What groups are you involved with on campus? List them here.
C. Background Check
In order to ensure a safe environment for the Camp Kesem campers and to comply with the
standards set by the American Camping Association and requirements of Stanford University, we
require a FBI level criminal background check of all accepted counselors.
If you have you ever been arrested, charged, convicted, or plead guilty to a crime (including
felony, misdemeanor, alcohol-related offenses, DUI, etc) please attach an additional sheet
explaining the arrest, charge or conviction. Arrests, charges and convictions do not
automatically disqualify you from serving as a Camp Kesem counselor, however failure to
report any prior arrests, charges or convictions could disqualify you from being eligible to be a
counselor.
Please sign below to acknowledge your understanding of, and compliance with, this policy.
Signature
Date
D. Counselor Agreement
In order to ensure that you can plan appropriately for Camp Kesem and know
what is expected of you ahead of time, please read below and sign to indicate
your understanding and acceptance of the expectations. If you have any
concerns, reservations or questions about any of these items, please let Emily
Mann and Ben McKenzie, Counselor Coordinators, or, Heather Paul, Camp
Director, know so that we can answer any questions and if necessary make
alternative arrangements.
I understand that if I am offered a counselor position with Camp Kesem and I
choose to accept the position, I will be expected to:
●
Have a LiveScan Criminal Background Check performed by the Stanford
Sherriff's department in order to ensure adequate time for the background
check to be processed prior to camp (detailed information will be provided
after selection).
● Return a Medical History form and copy health insurance card no later
than June 1, 2013 in order to ensure that proper care can be provided in
the event of an emergency (detailed information will be provided after
selection).
● Attend Counselor Training, April 5, 2013, starting at 5pm, through April
7, 2013 at 5pm. Make-up trainings may be provided on a case-by-case
basis and will be necessary for anyone who does not attend training.
● Attend additional trainings as necessary for additional responsibilities I
take on (i.e. Program counselor, Outdoor Leadership Program counselor,
etc).
● Serve as a counselor the entire week of Camp from June 17, 2013 at
8am through June 23, 2013 at 5pm.
● Attend counselor debriefing immediately following camp, from June 23 at
5pm through June 24, 2013 at 12noon.
● Participate in fundraising efforts to make Camp Kesem 2013 possible.
Such fundraising efforts may include but are not limited to letter writing
campaigns, online fundraising, events, unit fundraisers, etc.
● Participate in camp preparations with my unit to prepare materials, create
unit theme, name tags, etc, and bond with my unit counselors.
● Assist with general camp preparations as my schedule allows.
● Participate in general camp events and activities such as Spring Reunion
and Kickoff, Counselor Bonding Activities, etc as my schedule allows.
● Represent CK in a positive manner consistent with the values of Camp
Kesem.
I have read the expectations of a Camp Kesem counselor and agree that if I am
selected as a counselor and accept the position I will fulfill these expectations:
Signature
Date
E. Counselor Positions
Cabin Counselors and Units
All Camp Kesem counselors are cabin counselors, meaning that they spend
the majority of their time doing activities with their units (groups of campers) and
spend the night with the campers in their cabins.
The campers are broken into units based on their grade level. Please rank the
grades you would most like to work with in order from 1, being the most
desirable, to 5, being less desirable. Please feel free to put an X through any
grades that you would absolutely NOT want to work with.
(This information will be used when assigning counselors to their units).
_____ 2nd-3rd Grade _____ 4th-5th Grade
_____8th Grade
_____6th Grade
_____7th Grade
_____ 9th Grade
______ Outdoor Leadership Program (10th/11th Grade)
Outdoor Leadership Program (OLP)
The Outdoor Leadership Program (OLP) consists of the two units at Camp
Kesem reserved for the oldest group of campers (primarily finishing their
freshmen and sophomore years of high school). It focuses on team building and
leadership skills and culminates in a multi-day backpacking trip at the end of the
week of camp. OLP counselors should have an interest both in Camp Kesem
itself and specifically in working with older campers in the context of outdoor
leadership.
In addition to participating in all Camp Kesem preparations and commitments,
counselors selected to participate in OLP will be required to attend a 1-2 night
outdoor education training weekend in spring quarter. If you are interested in
working with OLP, please respond to the question below.
Question for OLP applicants
1) Why are you interested in participating in OLP? Please indicate any relevant
experience you may have, both in terms of working with this age group or with
regards to outdoor experience.
Program Counselors
As a new counselor applicant you are also eligible to be a Program Counselor.
In addition to the regular duties of a Cabin Counselor, a Program Counselor
splits their time between their units and planning/running specific activities for all
campers. The particular activities, or rotations, run by program counselors
include arts & crafts, drama, sports, and adventure/nature. If you are interested
in working as a Program Counselor, please rank the position(s) you are
interested in and respond to the following questions.
_____ Arts & Crafts
____Drama
____Sports
____Adventure/Nature
Questions for Program Counselor applicants
1.) Why are you interested in being a Program Counselor? Please indicate any
relevant experience you may have.
2.) Camp Kesem is always looking for ways to improve and expand
programming. Do you have any ideas for a program activity you would be
interested in leading that has not been mentioned? If so, what is it?
PLEASE NOTE: Indicating an interest in an optional position will not help or hurt your
chances of being accepted as a counselor. Please note that Program Counselors will
also participate in an additional training session. If you have indicated that you would be
interested in being a Program Counselor please anticipate being asked to describe
potential program activities in your interview.
F. Short Essays
1. Describe a favorite childhood memory.
2. If you could time-travel to any day in your life—past, present, or future—what
would it be?
3. What is your spirit animal and why? (By spirit animal we mean the animal that
most closely characterizes your personality.)
4. If you were trapped in a mall, what would be the first 3 things that you do?
5. If you could have any superpower, what would it be and why?
6. Why do you want to be a Camp Kesem Counselor?
Camp Kesem Counselor Recommendation
(Please fill out the following information and give this page to your recommender)
Applicant’s Name__________________________________________________
Last
First
Middle
____ I waive my right to review the content of this recommendation.
____ I do not waive my right to review the content of this recommendation.
____________________________________________________
Applicant’s signature
Date
Camp Kesem is a weeklong overnight camp for children in Grades 2-11 who have a
parent currently suffering, in remission, or has died from cancer. The needs of our
campers are many and varied, from a friend to play kickball or make friendship bracelets
with, to a shoulder to lean on, an ear to listen, or a comforting face to help them get over
a bad dream. As a result, we are looking for counselors from numerous backgrounds:
we welcome improvisers, artists, athletes, actors, nurturers, naturalists, dancers,
singers, and more. However, what truly sets our counselors apart is their generosity,
care, and compassion.
Taking the above into account, we have selected questions that will give us valuable
insight into how this applicant might fit with our group and goals. The Camp Kesem
Selection Team would like to thank you for agreeing to write a candid recommendation
for this applicant, and we truly appreciate and value your opinions of the applicant’s
abilities and accomplishments. When you have completed the recommendation form,
please return it to the applicant in a sealed envelope. The applicant will then be
responsible for delivering it to us with his/her application materials. Alternatively, you can
mail the form to us; you will find our mailing address at the bottom of this form.
If you have any questions please feel free to our Camp Director, Heather Paul, at (650)
723-1603.
Thank you again for your input.
1. Please briefly describe the capacity and context in which you have known the
applicant, and for how long.
2. Please describe a time when you have witnessed the applicant interacting in a
group. What are his/her strengths in working with a group? What are his/her
weaknesses?
3. How do you feel the applicant would interact with fellow counselors at camp?
4. How well do you feel the applicant would interact with the campers? Please
consider the range of ages our camp serves, and how the applicant might
interact with children of different ages.
5. Do you have any reservations about the applicant working with children?
6. Is there anything else you would like to add?
Recommender Name __________________________________________
Fist
Last
Email address_______________________________________________
Phone Number______________________________
Signature
Date
Thank you again for your time and candidness. Please remember to return this form in a
sealed envelope to the applicant. Or, if you prefer, you can return it to Hillel at Stanford
located at 565 Mayfield Ave at the corner of Campus Drive and Mayfield in a sealed
envelope with the applicant’s name, or you can mail it to:
Camp Kesem
c/o Hillel at Stanford
P.O. Box 20526
Stanford, CA 94309