Application for Staffing Position

Please complete this form, and 2 emails will be required: one must be completed by your Senior Pastor for recommendations.
Section I: Personal Information
Full Name
Date of Birth

MonthDayYear

Select Pastor's Name
If "Other" was selected enter Senior Pastor Email
example@example.com
Please enter email for 2nd recomendation.
example@example.com
Please enter a name for 2nd recomendation.
Is your Church a member of the P.A. of W., Inc.?
If no, please list your affiliation:
Have you been baptized in the Name of Jesus Christ for remission of sins according to Acts 2:38?
Have you received the gift of the Holy Spirit with evidence of speaking in tongues?

Are you a full member in good standing at your local assembly?
What activities or auxiliaries (ministries) are you presently involved in? (List up to 4)
Briefly describe any previous work with youth in your local assembly.
Section III: Academic & Experience Information
What is the highest level of education you have completed?

Have you ever been accused of or convicted of a crime involving minors under age 18? (If yes, please explain. Use additional sheet if necessary.)
I affirm that the information provided above is true and accurate to the best of my knowledge. I authorize the investigation of any and all information contained within this application including a criminal history/background check. I also understand that failure to provide true and accurate information may result in my dismissal from camp duties at any time. I also authorize the use of photographs and videotape pictures of myself during my week of service to be reproduced in print or electronically by the Youth Camp.
Date of Application

MonthDayYear
Date
Should be Empty: