* 1. Name

* 2. Date of birth

* 3. Email address 

* 4. Current city and state of residence 

* 5. Program(s) of interest

* 6. Do you have any experience working with children or individuals with disabilities? If so, please describe.

* 7. Have you previously volunteered at any iCan Shine program?  If so please list program(s), date(s) and location(s).

* 8. What are your future plans? (School, career goals, etc.)

* 9. What is the first date you would be available to work at a summer camp full time beginning June 1st?

* 10. What is the last date you would be available to work at a summer camp full time? (With programs ending August 31st)

* 11. This position requires travel.  Do you have any reasons that would preclude travel?

* 12. Are you able to be away from home for extended periods (six to eight weeks)? 

* 13. Additional Comments

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