Adult SEEK New Counselor/Staff Application

NEW Counselor/Staff Application

Adult SEEK Camp -- JUNE 8-11, 2023
Counselor/Staff Name

First NameLast Name
Birth Date*

MonthDayYear
Gender*
If you are 18 or older on June 1, 2023, you must submit a background check form. Once your registration has been confirmed,we will send you a link for your backgound check.
Parent/Gaurdian Email address (if under 18)
Counselor/Staff E-mail*
Counselor/Staff Mobile Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
T-Shirt Size*
How did you learn about SEEK Camp?
If you were referred by someone, please provide their information below:
Referred by (name):
Referred by contact (phone or email):
Church Affiliation/Membership (if applicable)
Church Staff Contact Name
Church Contact E-mail
List your experience working with children and/or youth:
List any experience you have working with special needs:
Permission to use photos on website/Facebook?*

YesNo
Check the box that you understand the date/time requirements stated above.

I understand.
If you have any questions please email Jerry at jerryljones313@gmail.com
Should be Empty:

NEW Counselor/Staff Application