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Kesem Volunteer Application 2027

Thank you for your interest in Kesem. We're so excited you're here!

This application covers many of our volunteer positions with Kesem. Please read about the position descriptions here. 

If you'd like to review the narrative questions that will be asked later in the application, click here. 

If you'd like to apply for an additional position and you have already submitted an application, please email support@kesem.org for assistance. 
Applicant Information



If you haven't selected one yet, put "Undecided".

This may be what you consider your "home chapter". If you don't have a primary chapter, please leave this field blank. 

MM/DD/YYYY






By clicking this box you give permission to Camp Kesem to send text messages to the mobile phone number(s) provided.Your information will not be shared with third parties. Message and data rates may apply.

Please enter in a non ".edu" email address

By clicking this box you give permission to Camp Kesem to send you emails to the address(es) provided. Your information will not be shared with third parties.






Kesem Involvement










Please note: Nurse, MHP, 1:1 Aid, and Interpreters are under the Health & Wellness Team option. You can find the position descriptions here.

New this year: If you are applying to be a Photographer/ Videographer only, you do not also need to select Counselor.

Please select all that apply

If you are applying to be a counselor this summer, please select "Yes" unless you are a current Kesem alumni who is applying to return as a counselor post-graduation.


To select multiple options, press Command + Click (Mac) or CTRL + Click (PC)


select "Other" if your school is not listed




To select multiple options, press Command + Click (Mac) or CTRL + Click (PC)




Health and Wellness Team Session Selection
You can apply for up to 5 sessions here. Please only choose the sessions for which you are available and willing to attend.

If you are available and willing to attend multiple sessions, but do not have certain sessions in mind, please indicate that below and a member of our team will reach out to you with potential placements. Travel reimbursements may be available.

To view all sessions, locations, and dates, please visit this map for more information.


MM/DD/YYYY

Share anything that may be helpful for us to know when reviewing your application for the session(s) you selected. If not, you may leave this blank.

This does not commit you to any additional sessions. It helps us understand whether you may be available if additional staffing needs arise.

This does not commit you to any additional sessions. It helps us understand whether you may be available if additional staffing needs arise.

Session 1 Selection

Session 2 Selection

Session 3 Selection

Session 4 Selection

Session 5 Selection

Counselor/Photographer Session Selection

Select the camp session for your Counselor, Photographer, Videographer, or "Other" application. This selection does not affect any other application types you have selected.
Kesem Together Session Selection

Initial Narrative Questions


Additional Narrative Questions



Additional Narrative Questions





Qualifications






Some participants may need 1:1 support at camp due to medical, behavioral, or other support needs. Selecting “Yes” means you may be contacted if a chapter has a need for 1:1 support. It does not commit you to serving in this role.

To select multiple options use (COMMAND+Click) or (CTRL+Click)
Volunteer Requirements
Please check each box to acknowledge that you understand and agree to the following requirements if selected to be a Counselor:
Camp Advisor/Hotline Operator

To select multiple options use (COMMAND+Click) or (CTRL+Click). Please select "N/A" if you have not advised a chapter


Number only




Registration Review Volunteer





Club Kesem Registration

Select all that apply






Health + Wellness Team Certifications






To select multiple options, press "Command+Click" on Mac, "CTRL+Click" on PC






Applicant Employment History
Yes No








Camp Volunteer Position Details



i.e. Arts & Crafts, Dance/Drama, Adventure, Nature, Sports, Cooking

Teen Leadership Program (age 17-18) Counselors must be at least 21 years old as of the first day of camp. NOTE: We cannot guarantee you will be put with your preferred age group.

Assistance Needed


Health History Questions
The responses below will not impact the selection process for camp. Health insurance and ability to drive do not impact application standing and are not required to participate. 
Yes No

Dietary Restrictions


Allergy Details

Select all that apply.



Chronic Illness



Immunizations
Because our camp program has a potential for communicable diseases, we recommend that program participants are appropriately immunized for, at minimum, the following diseases: tetanus, mumps, measles, rubella, polio, pertussis (whooping cough), and diphtheria. This being said, we recognize that some individuals may not be fully immunized for reasons that are biophysical (e.g., the individual is allergic to a serum component) or of personal choice (e.g., faith or belief).





Primary Care Physician Contact





Health History Confirmation
This health history is correct and accurately reflects the health status of the individual to whom it pertains. The individual described is able to participate in all activities except as noted by me and/or an examining physician. I give permission to the physician selected by Kesem to order x-rays, routine tests, and treatment related to my health for both routine health care and in emergency situations. I give my permission to the physician to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for me. I understand the information on this form will be shared on a “need to know” basis with Kesem Staff. I give permission to photocopy this form. In addition, Kesem has permission to obtain a copy of my health record from providers who treat me and these providers may talk with the program’s staff about my health status.

The responses below will not impact the selection process for camp. Health insurance and ability to drive do not impact application standing and are not required to participate. 
Health Insurance Information






Driving Information
Yes No





Please include contact information for two emergency contacts below who can be reached in the event of an emergency and are authorized and available to pick you up if the need arises.
Emergency Contact #1






Emergency Contact #2






Please provide the contact information for three references who can speak to your experience.
Reference #1





Reference #2





Reference #3





Demographic Questions
Kesem collects demographic information to better meet the needs of the communities we serve by identifying and addressing any gaps in our outreach and support. This information also can be used to gain critical funding to support our programs. These questions are completely optional. 

All responses remain confidential.






To select multiple options: "Command+Click" for Mac; "CTRL+Click" for PC




Waivers and Agreements
Please read the following waivers and agreements carefully. They include release of liability and waiver of legal rights, and deprive you of the ability to sue certain parties. By agreeing electronically, you acknowledge that you have both read and understood all text presented to you as part of the registration process.
By entering my name below, I assert that I have reviewed and agree to all the waivers and agreements I selected above:

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