Summer 2015 Camper Application * indicates required field Personal Info First Name:* Middle Name: Last Name:* Primary Contact Person:* Please indicate email address to be used for official correspondence: Email:* Home Phone Number: Street Address:* City:* State:* Zip:* Nationality:* Place of Birth:* Date of Birth:* Camper's Age as of July 2017:* Camper's Email (optional): Mother's Name:* Mother's Phone:* Mother's Email:* Mother's Occupation & Firm:* Father's Name:* Father's Phone:* Father's Email:* Father's Occupation & Firm:* School and Camp Info School and Grade Attending Fall 2017:* Schools Previously Attended:* School Conduct:* Excellent Very Good Good Fair Weak General School Work:* Excellent Very Good Good Fair Weak Name and Phone Number of School Principal:* Have you been to sleep-away camp before?* Yes No Camps Previously Attended: Do you play a musical instrument? If so, what and for how long?* Have you studied dance or voice? Please describe.* Did you see "A Light for Greytowers", "The Heart that Sings", "Operation: Candlelight" or the Camp Bnos Yisrael series?* How did you hear about Kol Neshama?* Why do you want to attend this summer?* Anything else you'd like to tell us? (optional) Travel Arrangements Campers may join the group flight, or can arrive at campus on their own. If you do not have a passport please apply for one immediately. New laws require that your passport does not expire within 6 months after travel date. If you will be making your own arrangements, please indicate here. Flight Arrangements:* Name on Passport: Passport Number: Passport Expiration: References List 2 references (Rabbi, school teacher or principal, etc.) with contact info. Reference #1 Name:* How you know Reference #1:* Reference #1 Phone (if possible, include home/work and cell):* Reference #2 Name:* How you know Reference #2:* Reference #2 Phone (if possible, include home/work and cell):* I have read and agree to Kol Neshama's Tznius Policies I need to schedule an interview with the Kol Neshama staff I am a KN alumna or have already been interviewed by Robin Garbose Please attach photo: Acceptable file types: doc,pdf,txt,gif,jpg,jpeg,png.Maximum file size: 1mb.