Immerse Application

Basic Information
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender*

MaleFemale
Date of Birth*

MonthDayYear
TRACK 1 - Seeking a discipleship + life skills + vocational experience before moving on to college/vocation
- Recent HS graduate seeking clarity before enrolling in college/trade school
- Young adult who recently obtained or is working on obtaining their GED looking for guidance in their next steps.
- Young adult transitioning out of the Foster Care system
TRACK 2 - Seeking discipleship + life skills + vocational experience while taking a break from college/vocation:
- College student wanting a gap year to reassess their major
- Young adult in the workforce wanting to reimagine/redirect their vocational path
TRACK 3 - College student seeking an unpaid internship for completion of their degree plan before graduation from college

TRACK 4 - College graduate seeking a post-grad internship (possibly paid) to gain work experience while using their degree/skills in camp-related ministries
Which of these options best describes your situation?*

Track 1Track 2Track 3Track 4

Track 1 - Participant Info
Please check all of the options that best describe your current situation:*

Highschool graduateGED obtainedGED in progressTransitioning out of Foster CareWanting to pursue an 2yr or 4yr college degree after this programUnsure of what major / vocation you would like to pursueUnsure if you want to pursue college or vocational trainingWanting to pursue vocational training
What about the Immerse program is most interesting to you?*
How do you hope an internship with Camp of the Hills will help you reach your future goals?*

Track 2 - Participant Info
What level of college or vocational training have you already completed? (ie number of credits or years)*
What was your area of focus? (ie major, minor, vocational program, jobs held, etc) *
If you are taking a gap year, please describe what vocational skills you are hoping to pursue at Camp of the Hills. *
What about the Immerse program is most interesting to you?*
How do you hope an internship with Camp of the Hills will help you reach your future goals?*
If you were designing an ideal post-internship career for yourself that was going to utilize your talents/passions and be fulfilling for you, what would it look like?*

Emergency Contact Information

for all participants (Tracks 1-4)
Who will you be listing as your emergency contact?*

ParentLegal GuardianOther
What is your Emergency Contact's relation to you? *
Emergency Contact Name *

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
Emergency Contact Email*
example@example.com
Personal Faith Story

Use the space below to write a brief description of your spiritual journey, including how you became a Christian, who has influenced your faith, and what events have shaped you. (This should be at least one page typed in a word processor.)
What is your personal story of faith?*
References

In order to be considered for the program, you must have at least three references COTH can contact. (Note that references should be adults to whom you are not related.)
Reference #1
Pastor, Minister, or other Christian professional*
Title, First Name, Last Name
Email
example@example.com
Phone Number

Area CodePhone Number
Reference #2
Employer*
Title, First Name, Last Name
Email
example@example.com
Phone Number

Area CodePhone Number
Reference #3
Personal reference of your choice*
Relation to you/Title, First Name, Last Name
Email
example@example.com
Phone Number

Area CodePhone Number

Personal Questions
How do you expect to grow through this internship and what do you expect to bring to the table as an intern?*
Which of your strengths do you believe will be most useful at Camp of the Hills?*
Which of your weaknesses will you need to overcome in order to be effective in a role at camp? How do you plan to address them positively?*
What other kind of things can you do? Which of your interests might be helpful in a camp ministry context? (music, acting, speaking, etc.)*
Have you ever been convicted of a felony? (Note: A yes does not automatically disqualify you from working at Camp of the Hills.)*

YesNo
If yes, please explain below.
Are you currently under indictment or on probation for any crime? (Note: A yes does not automatically disqualify you from working at Camp of the Hills.)*

YesNo
If yes, please explain.

Agreements
I understand that if I accept a position at COTH, I would be committing myself to a position of service, and my behavior and attitude should reflect Christ-like values.*

YesNo
I certify that the answers and the statements on this application are complete and true to the best of my knowledge and belief.*

YesNo
I understand that any false information, omissions or misrepresentations of the facts called for in this application may result in rejection of my application or discharge at any time during my internship experience.*

YesNo
I authorize all former employers, persons, schools, companies, and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies, and law enforcement authorities from liability for any damage whatsoever for issuing this information.*

YesNo
Signature

Clear
Should be Empty:

Basic Information