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Summer Staff
LIT
Volunteer Counselors
Internships
P E R S O N A L I N F O
Full Name (Required)
Gender
Male
Female
Street Address (Required)
City (Required)
State (Required)
Zip (Required)
Phone (Required)
Email (Required)
Shirt Size
S
M
L
XL
2XL
3XL
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Birthdate
Month
January
February
March
April
May
June
July
August
September
October
November
December
Month
/
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
/
Year
Marital Status (Required)
Marital Status (Required)
-----
Select...
Single
Married
Divorced
Parent/Guardian Name (Required)
Parent/Guardian Phone (Required)
Are you authorized to work in the U.S.?
Yes
No
If no, what certification do you have to work in the U.S.?
P E R S O N A L H I S T O R Y
Are there any limitations to your physical ability that we need to be made aware?
Yes
No
If yes, please explain:
Do you have any prior experience related to abuse, neglect, or abandonment?
Yes
No
If yes, please explain:
Do you have any training working with children who have been abused, neglected, and or abandoned?
Yes
No
Have you ever been denied the opportunity to work with children in any capacity?
Yes
No
If yes, please explain:
Have you ever been arrested for or charged with any criminal offense including but not limited to sexual crimes, violent crimes, or a drug and alcohol related crimes?
Yes
No
If yes, please explain:
Which of the following have you obtained?
High School Diploma
General Education Development
None
Name of High School (Required)
High school graduation
Month
January
February
March
April
May
June
July
August
September
October
November
December
Month
/
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
/
Year
When did you start/finish college?
Start Date
–
End Date
Names of colleges, universities, technical schools
Field(s) of Study
Degree(s) Received
List Certifications (First Aid, CPR, Lifeguard, AED, etc)
E M P L O Y M E N T
Previous Employer (Required)
Employers Phone Number
Position (Required)
Employment Dates
Start Date
–
End Date
Basic Responsibilities (Required)
Other Employment Record
List most recent employment first: Employer #2: (Employer Name) (Position) (Dates of Employment) (Employers Phone Number) (Basic Responsibilities) Employer #3: (Employer Name) (Position) (Dates of Employment) (Employers Phone Number) (Basic Responsibilities) Employer #4: (Employer Name) (Position) (Dates of Employment) (Employers Phone Number) (Basic Responsibilities) Employer #5: (Employer Name) (Position) (Dates of Employment) (Employers Phone Number) (Basic Responsibilities)
C H R I S T I A N F O R M A T I O N
Fill out responses in Word before submitting; answers may not be saved if the page times out
Is Jesus Christ your Lord and Savior?
Yes
No
1. How did you come to know Christ? How has that affected your life? (Required)
2. How would you share the gospel with a camper? (Required)
3. What ministries are you involved in? What are you doing to deepen your relationship with Christ? (Required)
4. What makes you excited to work at camp? What makes you nervous? (Required)
E X P E R I E N C E
Camp and Ministry Experience
Camp and Ministry Involvement Experience #1: (Name of Organization) (Position) (Dates of Service) (Supervisor Name) (Supervisor Phone) (Basic Responsibilities) Experience #2:(Name of Organization) (Position) (Dates of Service) (Supervisor Name) (Supervisor Phone) (Basic Responsibilities) Experience #3:(Name of Organization) (Position) (Dates of Service) (Supervisor Name) (Supervisor Phone) (Basic Responsibilities)
Church Name (Required)
How long have you attended this church?
R E F E R E N C E S
Full Name (Required)
Pastoral Reference:
Phone (Required)
E-mail Address (Required)
Full Name (Required)
Employer, Supervisor, or Teacher Reference:
Phone (Required)
E-mail Address (Required)
P R E F E R R E D S E S S I O N
First Preference (Required)
First Preference (Required)
-----
Select...
June 1st - June 13th
July 13th - July 25th
Second Preference (Required)
Second Preference (Required)
-----
Select...
June 1st - June 13th
July 13th - July 25th
Commitment of Honesty
I signify the above information is true and accurate to my knowledge
