Staff Application Name First Name Last Name Phone (###) ### #### Email * Date of Birth MM DD YYYY Marital Status Name of Church Pastor's Name Pastor's Phone (###) ### #### Do you consider yourself a born again believer in Jesus Christ? Yes No Explain how you came to faith in Jesus * Which camp are you interested in becoming a conselor for: Senior High Camp Junior High Camp Junior Camp Have you ever been dismissed from working with children? Yes No If yes, please explain circumstances: Have you ever been accused and/or convicted of any offenses other than minor traffic violations? Yes No If yes, please explain: Please give us two adults (non relatives) who will vouch for your faith and character: Reference #1 First Name Last Name Relationship Phone (###) ### #### Reference #2 First Name Last Name Relationship Phone (###) ### #### Are you willing to undergo a background check with local/State law enforcement: * Yes Thank you! Interested in becoming a camp counselor? Please fill out this application and we will get back to you!
