2018 RETURNING Summer Ministry Team Application

2018 RETURNING Summer Ministry Team Application
Please fill out this application ONLY if you worked at Simonhouse Bible Camp last year.
Personal Information
Name *

First Name Last Name
Birthdate *

- Month - Day Year
Gender *

Female Male

Present Address *

Mailing Address
Mailing Address Line 2
City	State / Province
Postal / Zip Code	Country

Permanent Address (if different from above)

Mailing Address
MailingAddress Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

- Area Code Phone Number
Cell Phone Number

- Area Code Phone Number
E-mail *
Social Insurance Number
Required for any honorarium
Are you a MANITOBA Resident? *

YES NO
MB Health Registration # *
5 numbers
MB Health Personal ID# *
9 numbers
OTHER Provincial Health # *
include two letters of province
Emergency Contact Information
Emergency Contact Name *

First Name Last Name
Relationship to you *
ie. Mother, Father, etc
Phone Number *

- Area Code Phone Number
Alternate Phone Number

- Area Code Phone Number
Church Information
Church You Attend *
City/Town *
Pastor's Name *
Pastor's Phone Number *

- Area Code Phone Number
Pastor's E-mail
Describe your church involvement/ experience *
Positions
Select the position(s) you are interested in

Administrative Assistant/Registrar Program Director Assistant Program Director CIT Director Counselor Counselor-In-Training Lifeguard Nurse/Medic Cook Kitchen Helper Maintenance Laundry
Availability
For cabin and program staff, preference will be given to staff who can participate in the full program. However, in the case where we are unable to fill our team with those able to come for the full program, we will fill as needed. With this in mind, please let us know your availability if you are UNABLE to fulfill the required commitment.
Are you able to commit to the full program? *

YES NO
If NO, please click why *

I can only do a portion of the summer program I need to leave but can come back
I'm only available from: *

- Month - Day Year
Until: *

- Month - Day Year
Comments
Date I need to leave *

- Month - Day Year
Date I would return *

- Month - Day Year
Reason *
Education
Are you in school now? *

YES NO
What grade will you have completed by June? *
Experience
Please list your previous camp experiences and positions held *
Please specify where, when and in what role
Please describe your previous employment/volunteer experience. *
List any employers and the amount of time at each, as well as any volunteer service.
Tell Us About Yourself
What led you to re-apply with the team at Simonhouse Bible Camp this summer? *
Self Evaluation - Please consider the following and click the number that best represents you.

My Christian Life is evident to others *

	1	2	3	4	5
Rarely						Consistently

I study the Bible regularly *

	1	2	3	4	5
Rarely						Consistently

My Faith continues to grow *

	1	2	3	4	5
Rarely						Consistently

I am actively involved in church *

	1	2	3	4	5
Rarely						Consistently

I apply Biblical principles to life *

	1	2	3	4	5
Rarely						Consistently

I am dependable *

	1	2	3	4	5
Rarely						Consistently

I take pride in my work *

	1	2	3	4	5
Rarely						Consistently

I follow instructions carefully *

	1	2	3	4	5
Rarely						Consistently

I am open to correction *

	1	2	3	4	5
Rarely						Consistently

I avoid conflict *

	1	2	3	4	5
Rarely						Consistently

I am more of a follower than a leader *

	1	2	3	4	5
Rarely						Consistently

I encourage others *

	1	2	3	4	5
Rarely						Consistently

I need encouragement *

	1	2	3	4	5
Rarely						Consistently

I am positive *

	1	2	3	4	5
Rarely						Consistently

I enjoy working with children *

	1	2	3	4	5
Rarely						Consistently

I procrastinate *

	1	2	3	4	5
Rarely						Consistently

I am quiet and reserved *

	1	2	3	4	5
Rarely						Consistently

I have a good sense of humor *

	1	2	3	4	5
Rarely						Consistently

My peers look to me as a leader *

	1	2	3	4	5
Rarely						Consistently

I manage anger well *

	1	2	3	4	5
Rarely						Consistently

I am outgoing *

	1	2	3	4	5
Rarely						Consistently

I have outdoor living experience *

	1	2	3	4	5
Limited						Extensive

I get anxious easily *

	1	2	3	4	5
Rarely						Consistently

I am creative *

	1	2	3	4	5
Rarely						Consistently

I am calm in nature *

	1	2	3	4	5
Rarely						Consistently

I enjoy opporunities to lead *

	1	2	3	4	5
Rarely						Consistently

COMMENT on your self-evaluation above or anything that was missed that we should know
Personal Testimony
Describe your relationship with Jesus over the past year *
What have you learned about God and yourself over the past year? *
During personal/sharing time, what Bible teaching would you stress to the campers? *
Certifications
Lifeguard Certification *

YES NO
Lifeguard Level *
Certifying Organization *
ie. Lifesaving Society, Red Cross, etc.
Nurse/Medic Certification *

YES NO
Nurse/Medic Level *
Certifying Organization *
ie. College of Nurses, Province of Manitoba, etc.
License # *
First Aid Certification *

YES NO
First Aid Level *
Certifying Organization *
ie., Red Cross, St. John's Ambulance, etc
CPR Certification *

YES NO
CPR Level *
Certifying Organization *
ie., Red Cross, Heart & Stroke Foundation, etc.
Climbing Wall Certification *

YES NO
Climbing Wall Level *
Certifying Organization *
ie., CWA, ACCT, ACMG, etc.
Check off all Interests & Skills

Guitar Piano Leading Music Drama/Skits Photo/Video Editing
List any other Interests & Skills
Employment Information
Simonhouse Bible Camp is committed to the protection and safety of children from abuse and asks the following questions to ensure the protection of children in our care:
Have you ever been convicted for a criminal offense related to sexual, emotional, or physical abuse? *

YES NO
Would you object to a Criminal Record Check or Child Abuse Registry Check by camp management? *

YES NO
Each team position includes mandatory in-service training. Remuneration ranges from volunteer for some positions to a weekly honorarium for others. Staff Training is not elegible for honorarium except for senior staff who provide leadership for it. The Extra Wages Program is also available to assist eligible staff to raise funds for educational costs.
Honorarium *

I wish to volunteer my time I will require an honorarium for my service
Extra Wages Program

I would like to apply for the Extra Wages Program
Name of post-secondary school you are enrolled in for next year:
Statement of Faith
Please click here to view our Statement of Faith. If you are selected for the ministry team, you will be required to sign and return this form.
I have read, agree and will support/teach in line with the Simonhouse Bible Camp Statement of Faith *

NO YES
Declaration
The completion and submission of this form is merely an application. After reference forms have been received and processed, you will hear from us regarding an interview and potential acceptance. Applications will be kept on file.
In submitting this application I declare that all of the information is accurate and true to the best of my knowledge. *
First and Last Name
Enter the message as it's shown *
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2018 RETURNING Summer Ministry Team Application

Personal Information

Emergency Contact Information

Church Information

Positions

Availability

Education

Experience

Tell Us About Yourself

Personal Testimony

Certifications

Employment Information

Statement of Faith

Declaration