Blast 2022 Senior Counselor Interest Form

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Thank you for your interest in being a counselor for 2022! The camp will be at Rock Eagle this year! By completing this form, you are making a commitment to serve from July 15th-19th. If you are accepted and something major comes up, you will work with Holly Shih to find a suitable replacement for your spot.

First Name *

Please type the your name as it should appear on your name tag.

Last Name *

What gender pronouns do you use? *

Date of Birth

YYYY

Your Email Address *

Your Cell Phone Number *

Emergency Contact Name *

Emergency Contact Phone Number *

T-shirt Size *

School and other Relevant Information *

Please share which GASC school(s) you have worked at and any special information that would be relevant to the position.

Why are you interested in being a BLAST counselor? What experiences are you most hoping to gain as a camp counselor? *

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