WCBC Staff Application (JCL & Clean)

Staff Application
Name:

First NameLast Name
Birth Date

MonthDayYear
Phone Number
E-mail Address:
example@example.com
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position
Church Attending
Pastor
Pastor Email
example@example.com
Job Skills & Training
Education
Testimony
Why do you want to work at Camp?
Health Information
Emergency Contact

First NameLast Name
Phone Number
Current Medical Conditions

Other
Conditions that might hinder your abilities:
I give my permission to the doctor selected by the camp to hospitalize, secure treatment, perform surgery, and prescribe medications as deemed necessary.
Medical Release Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Applicants Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
PARENT'S OR GUARDIANS SIGNATURE
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: