Camp Akita RETURNING STAFF Application- Summer 2025

Returning Staff Application

Summer Camp 2025
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
DOB*

MonthDayYear
Please select one*

MaleFemale
T-Shirt Size*
Jacket Size*
Cell Phone*

Area CodePhone Number
E-mail*
Are you a U.S Citizen? *
If No, please provide work authorization A#:
In the past year have you ever been arrested and/or convicted of a crime involving drugs, sex, or violence?*
If Yes, please explain:
Current Occupation:*
Supervisor's Name
Supervisor's Phone:
Are you a Seventh-day Adventist?*
Church name:*
Pastor:*
Your Address At School*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Major:
Minor:
Next Year's school plan:*
Grade:*
Thinking back to last summer, how would you describe your growth experience?
How have you been growing in your spiritual journey since camp?
How can the leadership team better serve you as a staff member, but also individually as a person?
Please List Three (3) references. (These individuals must not be related to you).
1. Name *

First NameLast Name
Position:*
(Pastor, Teacher/Dean, Work Supervisor)
Email:*
Phone #*
2. Name*

First NameLast Name
Position: *
(Pastor, Teacher/Dean, Work Supervisor)
Email:*
Phone #*
3. Name*

First NameLast Name
Position:*
Email:*
Phone #*
Is there anything that could hinder your work performance at camp (including health issues) *
If Yes, Please explain:
Present Health Condition:*
POSITION: Please list your first three job choices in order of preference, including qualifications and experiences, that would make you suitable for each positioned desired.
Previous Position:*
1st Desired Position:*
1st Desired Position*
Qualification/ Experience:*
2nd Desired Position: *
2nd Desired Position*
Qualification/ Experience:*
3rd Desired Position: *
3rd Desired Position*
Qualification/ Experience:*
Are you willing and able to commit a full nine (9) weeks to summer camp?*
If "No", please explain:
Skills:

Have you earned a new skill or certification during the year that you did not posses during camp last year?
If so, Please describe: *
Certification(s)
Check all that apply

ArcheryCHA (Horses)CPR/First Aid/AEDFood ServiceLife savingLifeguard InstructorWater Safety InstructorRock ClimbingCDL (Bus License)Boat DriverNone of the above
Positions: *

Archery InstructorCanoeing InstructorClimbing wall/Rappelling InstructorCounselor/Sub CounselorCraft InstructorHorse Wrangler/Horsemanship InstructorKitchen/Food Service StaffLifeguard/Swimming InstructorMaintenanceMountain Biking InstructorTubing Instructor/Watercraft DriverBoat Driver
If you are under 18 years of age, your parent or legal guardian must sign.

I hereby give permission for my child to work and reside at Camp Akita for the summer of 2020. I give my child permission to travel as necessary with other staff members for programs/events as required by the Director.
Parent or legal guardian's Name

First NameLast Name
Date

MonthDayYear
Confirmation of Applicant
Signature

Clear
Date:*

MonthDayYear
Should be Empty:

Returning Staff Application

Confirmation of Applicant