application form - YMCA of Greater Rochester

Introduction:
Hello, and thank you for your interest in Camp Eastside's LIT / CIT program!
This program is for teens who are dedicated to working with children and
creating and inclusive camp where all kids can enjoy their summer.
The first step towards that goal is to complete this application. Part I will
ask you to answer a few general background questions. Part II requires you to
discuss your own experiences with leadership. Please be as detailed as possible in
your responses. If you are applying to become a CIT, please be sure to complete
the extra Short Answer Response on page 5.
Lastly, you must find two (non family members) people to serve as
references who will recommend you for this program. All three parts of this
application must be returned to the Eastside YMCA by April 1st, 2013. The LIT / CIT
Coordinator will then review your application and contact you about an interview.
If you have any questions please email Michael Cardinali at:
michael.cardinali@rochesterymca.org
Now, let's get started! Please fill in the required information below:
Name:
Grade Entering Fall 2013:
Primary Address:
Home Phone Number(s) / Cell Phone Number:
Name of Parents or Guardians:
Parent Email Address:

Part I.
General Background Questions:
Please list any school clubs, extracurricular activities or sports of which you are a part:
Please list any Special Trainings or Certificates you have received (First Aid, CPR, Babysitting):
Please list any experience you have had working with children ages 5-12 in the past:
Please list any experience you have had working as a team with other teens (13-16 years old):
Choose one of the following skills in which you want to improve and one area where you already excel.
Give a detailed explanation describing your choices. (Public Speaking, Modeling Core Values [respect,
responsibility, honesty and caring], Initiative, Enthusiasm and Building Relationships [with children].
3

Part II.
Short Answer Response
LITs and CITs help to create a unique and inclusive atmosphere at Camp Eastside. Explain a time when
you helped to include someone who was being excluded or ignored:
Being a Leader means doing the right thing, even if it is not fun or exciting. Describe a time when you
had to make a difficult decision that you knew was right:
A good Leader takes initiative and actively guides their group. Explain a time when you sought out
responsibility or tried to fix a problem no one else was trying to correct.
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Part II. (Counselors in Training Only)
Short Answer Responses
If you have previously participated in the LIT or CIT programs please complete only Question One. If you
have not participated in the LIT or CIT programs please complete only Question Two.
Question One: How have you improved as a Leader through the LIT / CIT program and how will you use
those skills if you join the Counselors In Training Program this summer?
Question Two: Explain a time when you were a Leader, the lessons you learned through that experience
and how you are going to use them if you join the Counselors In Training Program.
5

Reference #1
To Be Completed By Applicant:
Name of Reference:
Reference Phone Number:
Relationship to Reference (must be non family member):
To Be Completed By Reference: And Returned With Application
The above mentioned teen has applied as a LIT or CIT with the Eastside YMCA Day Camp and has asked
that you provide a recommendation. Please answer questions honestly and constructively. Thank you
for your time and feedback!
1) How long and in what capacity have you known this teen applicant?
2) Below is a list of the characteristics that LITs and CITs refine throughout the summer program. Please
read through them thoroughly and evaluate:
•Public Speaking, Modeling Core Values (behavior displays respect, responsibility, honesty and caring),
Initiative, Enthusiasm and Building Relationships (how well do they work with children)
a) In what areas does this applicant excel?
b) In what areas does the applicant need to improve?
3) Why should we choose this applicant for the LIT or CIT program?
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Reference #2
To Be Completed By Applicant:
Name of Reference:
Reference Phone Number:
Relationship to Reference (must be non family member):
To Be Completed By Reference: And Returned With Application
The above mentioned teen has applied as a LIT or CIT with the Eastside YMCA Day Camp and has asked
that you provide a recommendation. Please answer questions honestly and constructively. Thank you
for your time and feedback!
1) How long and in what capacity have you known this teen applicant?
2) Below is a list of the characteristics that LITs and CITs refine throughout the summer program. Please
read through them thoroughly and evaluate:
•Public Speaking, Modeling Core Values (behavior displays respect, responsibility, honesty and caring),
Initiative, Enthusiasm and Building Relationships (how well do they work with children)
a) In what areas does this applicant excel?
b) In what areas does the applicant need to improve?
3) Why should we choose this applicant for the LIT or CIT program?
7