Yeshivas Kayitz Program The Hershey & Raisy Friedman Campus

Personal Info

• First Name
• Last Name
• Date Of Birth
• Hebrew Name בן
• Mothers Hebrew Name
• Home Phone
• Cell Phone
• Email Address
• Street
• City
• State
• Zip
• Country
• Select Size Youth Small Youth Medium Youth Large Youth XL Small Medium Large XL XXL Sweatshirt Size
• Select Size Youth Small Youth Medium Youth Large Youth XL Small Medium Large XL XXL Sweatpants Size
• Select Size 4 5 6 7 Yarmulka Size

Position

• Select Option Mechina Mesivta Beis Medrash Program

Education

• Yeshiva attended this year
• Shiur
• Teachers Name

Camp Experience

• Year
• Camp
• Position
• Head Counselor

• Year
• Camp
• Position
• Head Counselor

References

Give names and phone number of 2 or 3 persons (not relatives) having knowledge of your character, experience, work habits and ability.

• Name
• Position
• Phone

• Name
• Position
• Phone

Yeshivas Kayitz Guidelines

• As a staff member I understand that all my actions are watched and have a strong effect on the Bochurim.

• Answer

• I understand that getting drunk is unacceptable and will not be tolerated.

• Answer

• I understand that smoking is not allowed onsite.

• Answer

• I understand the negative effects of using my phone in front of bochurim and will refrain from using it when in front of bochurim.

• Answer

• I understand that as a staff member I am to behave like a Dugma Chaya and how a Chossid should.

• Answer

• I understand I am expected to be by Minyan 3 times a day.

• Answer

• I will not use inappropriate language.

• Answer

Questionaire

• As a staff member what do you consider your main responsibilities and objective?
  

• Explain

• What contributions do you think you can make at Yeshivas Kayitz?
  

• Explain

• What special skills and talents do you possess?
  

• Explain

• Do you have any allergies? (if yes please list)
  

• Explain

• Do you have any eating limitations? (if yes please list)
  

• Explain

• Do you take any medications? (if yes please list)
  

• Explain

• Have you been diagnosed with any condition?
  

• Explain

• Have you ever needed psychological or psychiatric attention?
  

• Explain

• Do you have any health history? (if yes please list)
  

• Explain

• Please provide your medical insurance information.(carrier, policy name, id number...)

• Explain

Harassment

The camp’s policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment. Have you ever been accused of harassment of any person including, but not limited to, workplace harassment? (Note: a prior accusation is not an automatic bar to employment. The type of accusation and when it occurred will be evaluated by the camp before any decision is made.)

• No
• Yes
• Please Explain

Criminal Record

Have you ever been convicted of a crime, other than a minor traffic offense? If yes, please describe. (Note: a prior conviction is not an automatic bar to employment. The type of conviction and when it occurred will be evaluated by the camp before any decision is made.)

• No
• Yes
• Please Explain

Authorization