New Summer Staff Application 2023

GENERAL INFORMATION

Thank you for applying to serve on Gleanings For The Hungry Summer Staff. This application is for new Summer Staff. You are applying to return, please use the Returning Summer Staff Application.
FULL NAME*

First NameLast Name
EMAIL*
CURRENT ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
PHONE NUMBER*

Area CodePhone Number
BIRTHDATE*

MonthDayYear
T-SHIRT SIZE*
All shirts will be unisex fit
"GOOD" PHOTO OF YOU*
Upload a good photo of you. We need a clear, well-lit photo of your face. It will be used throughout summertime.
How did you hear about Gleanings for the Hungry, Summer Staff Internship?*
TIME COMMITMENT

We encourage all Summer Staff Leaders to serve as many weeks as possible to maximize the quality of your experience. The minimum time commitment is 6 consecutive week. Please contact us if you have any questions at summerstaff@gleanings.org.
- Select all the weeks you are committed to serve below
- Try your best to plan to arrive/depart on a Saturday or Sunday
Which Summer Staff weeks can you commit to serve? You must commit to a minimum of 6 consecutive weeks. (Select all that apply)

Week 1 May 28-June 3 (Launch Week)Week 2 June 4-June 10Week 3 June 11-June 17Week 4 June 18-June 24Week 5 June 25-July 1Week 6 July 2-July 8Week 7 July 9-July 15Week 8 July 16-July 22Week 9 July 23-July 29Week 10 July 30-August 5Week 11 August 6-August 12Week 12 August 13-August 19
TRAINING & WORK EXPERIENCE

Please tell us about your training and work experience outside of Gleanings.
What was your favorite work experience outside of Gleanings? Why?*
What unique skills and training have you received outside of Gleanings?*
What are 2-3 areas you are strong in?*
What are your interests?*
HEALTH INFORMATION
PHYSICAL HEALTH:*
Please select your current status of physical health.
EXPLAIN (IF NOT IN GOOD HEALTH):
Please explain any current or recent health issues you have experienced.
HEALTH INSURANCE:*

Yes, I currently have health insurance.No, I currently do not have health insurance.
NAME OF INSURANCE CARRIER:*
The name of your health insurance provider. If none, type n/a.
INSURANCE POLICY NUMBER:*
List your health insurance policy number. If none, type n/a.
OTHER HEALTH INFORMATION:
Please list any information that would be helpful to health and medical personnel. (Allergies, food allergies, recent hospitalizations, etc.)
ALLERGIES/DIETARY RESTRICTIONS:
Please list any information that would be helpful to our kitchen staff and/or health and medical personnel. (Allergies, food allergies, dietary restrictions/preferences, etc.)
MEDICATION:*
Please list any medication you are currently taking or will be taking during your service at Gleanings. If none, type n/a.
DRUGS & ALCOHOL:*
Please explain any current or past experience you have of drug and/or alcohol abuse. If none, type n/a.
LEARNING DISABILITIES:*
Have you ever been diagnosed with a learning disability? If so, please explain. (All information is confidential between Gleanings leadership reviewing these applications.) If none, type n/a.
MENTAL ILLNESS:*
Have you ever diagnosed with a mental illness (i.e. depression, anxiety, self harm, etc.)? If so, please explain. (All information is confidential between Gleanings leadership reviewing these applications.) If none, type n/a.
RECENT TRAUMA:*
Have you recently experienced any kind of trauma? If so, please explain. (All information is confidential between Gleanings leadership reviewing these applications.) If none, type n/a.
Emergency Contact Information
PARENT/GUARDIAN NAME:*
PARENT/GUARDIAN PHONE:*

Area CodePhone Number
PARENT/GUARDIAN EMAIL:
example@example.com
If under 18, do you have your parent's/guardian's consent for this commitment?
SECOND EMERGENCY CONTACT NAME:*

First NameLast Name
SECOND EMERGENCY CONTACT PHONE:*

Area CodePhone Number
SECOND EMERGENCY CONTACT RELATIONSHIP TO YOU:*
SAFETY RESPONSIBILITY:*

I hereby resolve Gleanings For The Hungry of responsibility for accidents which might happen during the time I am working with them. I will not hold Gleanings For The Hungry responsible for personal possessions lost, damaged or stolen on Gleanings premises. I acknowledge that my safety is my responsibility.
LIFE, SPIRITUALITY & FAITH STATEMENT
I acknowledge that Gleanings for the Hungry is a Christian organization and I understand that Gleanings' mission is to feed the needy of the world both physically and spiritually. I understand that the opportunity to take part in the Summer Staff Internship will involve spiritual activities such as prayer, worship, mission-minded work, spiritual conversations, and more. I also acknowledge that this is a leadership role, which will present opportunities to set an example, lead, guide, and counsel youth in matters of faith and spirituality.
Christian Ministry*

I acknowledge the statement above.
Are you a Christian?*
Describe a defining moment in your walk with Jesus and faith journey.*
Tell us a brief version of your life story.*
Which choice best describes your current involvement with a church (whether in-person or remote)?*
CHURCH NAME:
Please type n/a if does not apply
PASTOR'S NAME:
Please type n/a if does not apply
PASTOR'S EMAIL:
example@example.com
Briefly explain your personal support system, the important people in your life whom you trust for good counsel.*
SUPPORT PERSON'S NAME:*
SUPPORT PERSON'S EMAIL:*
example@example.com
PERSONAL RESPONSE
Why do you want to be a Summer Staff Leader at Gleanings for the Hungry? Please write a well-thought out response.*
Why does an individual's personal example matter?*
Which choice best describes how ready you are to receive and respond to personal evaluation, correction, and feedback?*
Which choice best describes how ready you are to surrender your personal habits and lifestyle to focus on the team's purpose?
Which choice best describes how you will deal with interpersonal conflicts?
List 3-5 of your top personal values. (Please answer very thoughtfully. This will be used in team building exercises)*
Gleanings directors have prayerfully selected a Summer Staff Empowerment Team of Captains to support and empower this team of leaders. What are your feelings about submitting to the authority of an Empowerment Team made up of your peers?*
Do you have any questions?
APPLICATION AGREEMENT

I agree to join in the vision and mission of Gleanings for the Hungry, to abide by the Summer Staff Packet 2023 (Read before applying) to commit to serve for a minumum of six consectutive weeks, to pay a $200/month Summer Staff fee.
Agreement

I wholeheartedly agree to the statements above.
Should be Empty:

GENERAL INFORMATION

TIME COMMITMENT

TRAINING & WORK EXPERIENCE

HEALTH INFORMATION

LIFE, SPIRITUALITY & FAITH STATEMENT

PERSONAL RESPONSE

APPLICATION AGREEMENT