Position Applying For
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Counselor
Operational Staff
Kitchen Staff
Personal Information
Name
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First Name
Last Name
Age
*
Sex
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Male
Female
Birthday
*
-
Month
-
Day
Year
Date
Email Address
*
example@example.com
Cell Phone Number
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Please enter a valid phone number.
Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School
Year in School
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Major
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School Name
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School Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School Phone Number
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Church
Home Church
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Pastor
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First Name
Last Name
Church Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Health Information
Do you have any restrictions that would make it difficult for you to engage in any sport or activity included in a full camp schedule?
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Yes
No
If so, please explain
List any allergies/allergic reactions?
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List any medications taken regularly
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Emergency Contact
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First Name
Last Name
Phone Number
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Experience
List any extra-curricular activities in which you have participated (high school and/or college).
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Do you hold any YMCA, Red Cross, or American Heart Association Certificates?
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Yes
No
If yes, which one(s)?
Do you play a musical instrument?
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Yes
No
If yes, which one(s)?
Have you worked at a camp before?
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Yes
No
If yes, which one(s)?
How confident and competent do you consider yourself to be in the following areas:
Rows
Little
Moderate
Very
Swimming
Water Skiing
Climbing Wall
Character
Briefly describe what you would consider to be the greatest spiritual lesson you have learned in the last year.
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List the areas of church ministry in which you have served.
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What do you hope to gain from serving at The Anchorage Camp this summer?
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Have you ever been accused of child abuse or a crime involving actual or attempted sexual molestation of a minor?
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Yes
No
Have you ever been convicted of anything other than a traffic ticket?
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Yes
No
If yes, please explain
Have you ever been dismissed from college or high school?
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Yes
No
If yes, please explain
Please give a brief testimony concerning your personal salvation.
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On what do you base your assurance?
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How have you discerned and accepted God's call for your life?
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Please upload a recent picture of yourself.
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