2021 CT Application | Fleur de Lis Camp

CT Basic Information

Name *

First

Last

Birthdate *

Current Grade *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

Shirt Size *

Will you be receiving at 10 year bracelet in summer 2021? *

Yes
No

Would you have recieved a 10-year bracelet in 2020? *

Yes
No

Essay

Attach a separate document: one page typed essay that gives careful thought to the question below.

Please share with us why you would like to advance your experinece at Fleur de Lis and participate in the Counselor in Training Leadership Program. What specific situations have lead you to make this decision, what will you bring to the program, and what are you looking to gain from this experience?

Click or drag a file to this area to upload.

Applicant & Guardian Consent

My parents and I understand that the intent of this program is to participate as a CT in this leadership development program. We also understand that the cost of the program is $5,600 years payable in full upon acceptance into the program.

Guardian Name *

First

Last

Guardian Email *

Signatures (electronic)

Per the state of New Hampshire, Env-Wq 904.02(d) I certify that because I will be working with campers as a CT at Fleur de Lis Camp that I have not (my daughter has not) been convicted for any criminal offense involving: • Causing or threatening direct physical injury to another individual; • Causing or threatening harm of any nature to any child or children; or • Unlawfully taking property of another, whether through force or threat of force or through deception.

Guardian Name *

First

Last

Applicant Name *

First

Last