Jr. Counselor (CIT) Form for Camp 2019 – Capen Hill Nature Sanctuary

Please fill out form below. If you would like to donate to this program (free for Jr. Counselors but donations would be appreciated ) please press the donate button!

New Counselor in Training (CIT) form Capen Hill Science and Nature Camp 2022 (Age 14 and up)

This form needs to be filled out by all volunteers.

New Counselor in Training (CIT) Form 2022

For new CIT's that have never been trained. Ages are 14 and up. You will be at Camp to help with the groups of campers according to age as well as receive community service hours. One-time fee is $150.
Name*
First Last
Street and Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Enter Email Confirm Email
Phone*
A short description of any previous experience.
List 3 references and phone numbers.
Additional Information you would like us to know.
Name*
First Last
Emergency Name and Phone Number
Phone*
Emergency Phone Number
Cori Info Needed: First Name, Last Name, Middle Name*
Cori Info Needed: Place of Birth*
Cori Info Needed: Date of Birth*
Cori Info Needed: Last Six Numbers of Social Security*
Current Address*
Cori Info Needed: Mother's First Name, Last Name and Maiden Name
Cori Info Needed: Father's First and Last Name
Cori Info Needed: State Driver's License Number If Applicable
Upload Vaccination Record
Max. file size: 2 MB.
Copy of your vaccination record needed. You may also have the doctor's office mail it to Capen Hill Nature Sanctuary, P.O. Box 218, Charlton City, MA 01508
Weeks you would like to volunteer (can always change)*
- Select All
- Session 1 (July 5- 9)
- Session 2 (July 12-16)
- Session 3 (July 19-23)
- Session 4 (July 26-30)
Camp runs for 4 one week sessions from 8:30 to 3. You can pick as many weeks as you want. If you want to change your plans. you are able to do so but you need to let the director know.
How would you like to pay*
- PayPal or. Credit Card
- Mail a Check
Choice one is Paypal or Credit Card. Credit Card payment is under the paypal login. Choice 2 is to send a check. Capen Hill Nature Sanctuary, P.O. Box 218, Charlton City, MA 01508
Counselor in Training Fee*
Price:
One time Fee for the Counselor in Training Course