JUNIOR COUNSELOR INFORMATION SHEET

. Students entering 7th grade have the opportunity to become Junior Counselors. This is an unpaid position, which prepares our young people to become future counselors. We prefer to hire counselors for two weeks and possibly more if space is available.

Name: ______Age: ______Grade Entering:______

Address: ______

Home Phone: ______Date of Birth: ______

1. Why would you like to be a Junior Counselor at the Meriden Community Camp?

2. Please provide some information about any previous experience you have had working with younger children.

3. Which week(s) are you available?

_____ June 26 – June 30 _____ July 24 – July 28 _____ July 3 – July 7 _____ July 31 – August 4 _____ July 10 – July 14 _____ August 7 to August 11 _____ July 17 – July 21

Meriden Community Camp ~ Junior Counselor Information Sheet ~ PO Box 187 ~ Meriden, NH 03770 JUNIOR COUNSELOR INFORMATION SHEET

Parent/Guardian Information Name ______Name ______Home Address Home Address ______Phone ______Phone ______Work Address Work Address ______Work Phone ______Work Phone ______Alt Phone ______Alt Phone ______E-Mail ______E-Mail ______

Pick up Information

___ My child has permission to walk home from Meriden Community Camp

___ My child has permission to walk from MCC to ______

___ My child has permission to receive a ride from ______

______

I give my permission to Meriden Community Camp to (check the ones you approve):

_____ Let my child walk with a buddy in and around the Meriden town center, within 3 miles of Meriden Congregational Church.

_____ Transport my child locally

Parent/ Guardian Signature ______Date______

Meriden Community Camp ~ Junior Counselor Information Sheet ~ PO Box 187 ~ Meriden, NH 03770