NEW TRAC Volunteer

TEEN REACH ADVENTURE CAMP CAMP COUNSELOR/STAFF APPLICATION
Select TRAC Camp you would like to volunteer at:*

Girls TRAC: January 17-20Boys TRAC: February 7-10
Date*

MonthDayYear
Date
Name*

First NameLast Name
Street*
City*
State*
Cell Phone*
Home Phone
Email*
example@example.com
Birth Date*

MonthDayYear
Date
Sex*
Marital Status*
Living Situation
Emergency Contact*
Phone Number*
T-Shirt Size
Have you ever been abused, neglected, or abandoned?*

NoYesPrefer to discuss in person
Have you committed your life to Jesus Christ?*

YesNo
Could you lead a 15-minute devotion for your campers with provided materials?*

YesNo
Which church do you presently attend?*
Pastors Name*
Phone*
Scan the QR code or follow hyperlink:

https://static1.squarespace.com/static/6217ef100bd53704ce6c4cac/t/64307d1d033d9c699e6b3b12/1680899358093/ Policy+for+TRAC-1.pdf
I have read, agree with, and will comply with the Teen Reach Statement of Faith, Volunteer Standards, and Position Statement.*

YesNo
Have you ever been arrested for a criminal offense?*

YesNo
Have you ever been arrested for sexual misconduct?*

YesNo
Have you ever been convicted of sexual misconduct?*

YesNo
Have you ever taken drugs other than those prescribed by your physician?*

YesNo
If you answered yes to any of the questions above please explain. If no, please write N/A.*
Education
High School*
Date of Graduation
College*
Date of Graduation
Other
Graduation
Do you have a certification in the following? (Select all that apply)*

CPRFirst AidLife GuardNurseEMTNone
Have you previously served at another TRAC program?*

YesNo
If yes, where?
When?
Why do you wish to be a volunteer at TRAC?*
Please describe your previous experience working with children or teenagers:*
Do you have previous training/experience working with abused, neglected or abandoned children/teens?*

YesNo
If so, please explain.
Please select the words which you believe accurately describe you?*

TimidMatureCongenialSecureVerbalRelaxedGentleSarcasticKindConsiderateOrganizedTactfulImpatientPatientStubbornAbrasiveImpulsiveCompassionateNervousAngryStudiousTrustworthyIntelligentLovingDeliberateSelfishMotivatedInsecure
List five strengths and weaknesses you have in working with teenagers or children (please be specific): My strengths are:
1*
2*
3*
4*
5*
My weaknesses are:
1*
2*
3*
4*
5*
Medical History
Can you hike at least 2 miles?*

YesNo
Do you have any medical conditions?*

YesNo
If yes, please explain.
Do you take any medications?*

YesNo
If yes, please list:
References

Please provide one professional, one ministry, and one personal reference:
Professional Reference*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Ministry Reference*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Personal Reference*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
I am interested in becoming a mentor:*

YesNo
I certify, under penalty of perjury, that my signature below signifies this information is true and correct to the best of my knowledge. I give permission for T.R.A.C. to request background checks for me to become a staff member/camp counselor for Teen Reach Adventure Camp.
Full Name*
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

TEEN REACH ADVENTURE CAMP CAMP COUNSELOR/STAFF APPLICATION

Education

Medical History

References