CIT Application

1Applicant Information

2Applicant Skills

3References

4Signiture

Name*
First Last
Birthdate*
MM slash DD slash YYYY
Gender*
- Male
- Female
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Have you been a camper at District 6 Language/Heritage Camp*
- Yes
- No
What years did you attend?*

List all years separated by a comma or use a - to indicate range, i.e: 2010, 2012-2014
Any other camp experience:*
- Yes
- No
Name of Camp
Years attended?*

List all years separated by comma or a dash to indicate a range, i.e: 2010, 2012-2014
List any Youth Organizations/Clubs you belong to:
none
Enter one name per line.
Name of School*
Education Level*
Indicate your highest level of education
Address of School*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Please list three adults (not relatives) who we can contact as references
Reference 1
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Reference 2
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Reference 3
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email

Save and Continue Later

Norwigian heiratage youth summer camp