Returning Summer Staff Application 2023

RETURNING SUMMER STAFF APPLICATION

This application is for returning applicants only. Thank you for applying to serve on Gleanings For The Hungry Summer Staff again! Please read and answer each question carefully then submit your application by April 30. Spots are very limited. Please apply as soon as possible. We love each of you and look forward to hearing from you. Please contact summerstaff@gleanings.org with any questions or concerns.
GENERAL INFORMATION
FULL NAME*

First NameLast Name
EMAIL*
example@example.com
CURRENT ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PHONE NUMBER*

Area CodePhone Number
BIRTHDATE*

MonthDayYear
T-SHIRT SIZE*
All shirts will be unisex fit
"GOOD & NEW" 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.
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 has increased--we now require a minimum 6 consecutive weeks. Please contact us if you have any questions at summerstaff@gleanings.org.

Select all the weeks you are committed to serve below.
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
Would you be willing to work with leadership to prepare ahead of time and lead training activities for new summer staff during Launch Week?*

YesNo
HEALTH INFORMATION

Please give us your current and updated 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.
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. (important medical history, 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 & SUPPORT CONTACT INFORMATION
PARENT/GUARDIAN NAME:*
PARENT/GUARDIAN PHONE:*

Area CodePhone Number
PARENT/GUARDIAN EMAIL:
example@example.com
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.
PERSONAL RESPONSE
Why did you decide to return? *
What is at least one things you have learned from being on Summer Staff in the past? *
How have you applied what you have learned throughout the past year? *
List 3-5 of your top personal values. (Please answer very thoughtfully. This will be used in team building exercises)*
Explain at least one area where you want to be challenged this summer in order for us to help you grow and become a better servant-leader?*
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?
How will you respond to any changes in this summer's work and program structures?*
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?*
Tell us about at least one important event from this past year from life outside of Gleanings that has significantly affected or impacted your life?*
Share something you have been praying about, or something you feel God has been putting on your heart recently? *
Briefly explain your personal support system, the important people in your life whom you trust for good counsel.*
SUPPORT PERSON'S NAME (Not a Parent):*
SUPPORT PERSON'S EMAIL (Not a Parent):*
example@example.com
PASTOR'S NAME:*
PASTOR'S EMAIL:*
example@example.com
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 current Summer Staff Packet (Read updated packet 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.
Gleanings for the Hungry

43029 Road 104 Dinuba, CA 93618

Email: summerstaff@gleanings.org

Tel. (559) 591-5009
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RETURNING SUMMER STAFF APPLICATION

GENERAL INFORMATION

TIME COMMITMENT

HEALTH INFORMATION

EMERGENCY & SUPPORT CONTACT INFORMATION

PERSONAL RESPONSE

APPLICATION AGREEMENT