• Staff Application

    Serving children in Michigan's Foster Care System, ages 6-13

  • All information is held strictly confidential. This form must be completely filled out and include a scanned copy of your photo ID (not a picture - we recommend the app ScanGenius or CamScanner). You must also complete the DHS Clearance Form before being fully applied. There is a section and link for the DHS Form below. The information is vital to your acceptance and possible placement as a volunteer.

  • Birthdate*
     - -

  • Please fill out this quick DHS Background Clearance Form. There will be a code given to you on the "Thank You" page you will need to enter below before you can submit your volunteer application. Follow the link below and then enter the code at the end of the application signifying you have completed and submitted the DHS form.

    DHS Background Check Clearance

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  • Race (according to iChat)*
  • Gender*
  • Which team are you applying for?*
  • Is your email different from last year?*
  • Format: (000) 000-0000.
  • Is your phone number different from last year?*
  • Are you retired?*
  • T-Shirt Size*
  • What position are you interested in applying for? (Check all that you are interested in!)*
  • If chosen as a Camp Counselor, I would prefer my campers' ages to be:
  • Please check any of the following certifications you currently have:*
  • Do you have previous training/background/experience in working with abused, neglected, or abandoned children?*
  • Have you been a victim of abuse, neglect, or abandonment?*
  • Do you have any medical conditions?*
  • Do you take any medications?*
  • Have you had any serious illness or injuries in the last three years?*
  • Do you have any physical handicaps or conditions preventing you from performing any type of activity?*

  • Education Background

  • PERSONAL REFERENCES

    **NO FAMILY/RELATIVES**
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Please select what you believe are your top 5 skillsets when it comes to working with children, adults, and volunteer opportunities:*
  • Do you feel you relate better to:*
  • If given materials, do you feel like you could lead a 15-minute devotion with your campers?*
  • Are you currently attending a church?*
  • Have you ever been arrested for a criminal offense?*
  • Have you ever been convicted of, or plead guilty, to a crime?*
  • Have you ever been arrested for sexual misconduct?*
  • Have you ever been convicted of, or plead guilty, to sexual misconduct?*
  • Have you ever taken drugs other than prescription drugs?*
  • Do you currently use tobacco?*
  • Do you currently use alcohol?*
  • Do you currently use drugs?*
  • Do you have any food allergies or dietary restrictions?*
  • Food Allergies:

  • Applicant's Statement:

    The information obtained in this application is correct to the best of my knowledge. I authorize any references listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children or youth work. In consideration of the receipt and evaluation of this application by Love For A Child, I hereby release any individual, church, youth organization, charity, employer reference, or any other person or organization, including record custodians, both collectively and individually from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. Signing this application agrees to allowing Love For A Child to use (photo/video) media documentation for sharing and marketing purposes publicly.

    I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act. This is a legally binding agreement which I have read and understand.

    Please be advised that a criminal history check will be requested from the state(s) of Michigan as authorized by state law.

  • Today's Date*
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  • Should be Empty: