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Camp Darom 2009 Staff Assistant Request Form

( For teenagers entering grades 9-10 in fall 2009)

  Your Name
  Date of Birth
 
Male Female
  Address
  City
  State
  Zip Code
  Phone Number
  Email
  Grade entering in Fall 2005
 

Educational History Please list all schools you have attended
Name
Location
Dates
Special notes (honors etc)
 
Camp History Please lest all camps you have attended
Name
Position
Dates
Day camp or over night
  List other work experience
  References - Please list two people we can contact

 
 

 

Camp Darom
A project of the Baron Hirsch Congregation
400 S Yates Road
Memphis, TN 38120
(901) 683-7485 www.baronhirsch.org
darom@baronhirsch.org