Summer Interest Form

1

Are you a:* This field is required.

New Applicant

Returning Applicant

2

What position(s) are you interested in?* This field is required.Choose one or more if applicable. Please check out the job descriptions on our website for more information on each of these positions.

Cabin Counselor

Poiema Counselor

Day Camp Counselor

Head Counselor (for Traditional Camps) [FILLED]

Head Counselor (for Poiema Camps)

Head Counselor (for Day Camps)

Lifeguard

Media Assistant

Office Assistant

Maintenance Assistant

Nurse Assistant

Waterfront Coordinator

Activity Coordinator [FILLED]

Discipleship Coordinator

3

Have you already filled out the nurse application?If not, please fill it out here.

YESNO

4

Are you interested in serving in any special ways such as:Choose one or more if applicable. These additional responsibilities may require a follow up interview.

Leadership Roles

Worship Team

Lifeguard

Media Support (tech, photography, etc.)

5

Full (Legal) Name* This field is required.

First Name

Last Name

6

Email* This field is required.

example@example.com

7

Phone Number* This field is required.

Area Code

Phone Number

8

Gender* This field is required.

Female

Male

9

How old will you be by May 24, 2026?* This field is required.

10

High School Graduation Year* This field is required.

(YYYY)