Summer Staff Application Form

Lost Valley Staff Application Form

We are looking for enthusiastic, committed, service-minded individuals or families who are able to minister at camp this summer! To complete the application you will need the name and contact information for 3 references (including a pastor). For more information about each position and our staff expectations visit https://tinyurl.com/LV-staff-info or email lostvalleybiblecamp@gmail.com.
Basic Information
Full Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birthday

MonthDayYear
Date
T-Shirt Size (Unisex)
Applying For (select any postions you are interested in):

Other
Are you applying for the Northpoint Grand Rapids/Lost Valley scholarship?
Camp Experience

We are required to collect camp experience as part of the application process per the State of Michigan. Please list any experience you have as a camper or camp staff.
Camper Experience
Camp Staff Experience
Prior Employment History

List your most recent and/or most relevant paid employment positions (at least 2). If you do not have ANY previous work experience put N/A and todays date.
Job Information
Drug History
Have you ever or do you currently use foreign substances such as tobacco, alcohol, marijuana, recreational drugs, or non-prescribed medications?
Additional Questions Required by the State of Michigan
Have you been convicted of anything other than a minor traffic violation?
Please explain any convictions:
Are you currently being treated for any infectious diseases?
Please explain any infectious diseases:
Are you currently infected with communicable tuberculosis?
Are there any health concerns you feel we should know about (back problems, sun sensitivity, mental health issues, etc.)?
Please explain any health concerns:
Interest
How did you find out about summer positions at Lost Valley?
Please explain why you want to work as summer staff at our camp and include a brief statement regarding any interest you have in working specific positions (i.e. Lifeguarding, Kitchen Staff, Maintenance, etc.)
By signing below, you confirm that all the information provided is accurate and complete.

References

Due to State guidelines all staff and volunteers are required to have 3 character references. We require that one of these references be a pastor; the other two should be completed by a previous employer, teacher, professor, guidance counselor, or school administrator. References from family members are not accepted. Please enter your references' information below and the appropriate reference form will be sent to each them automatically.
Pastor Reference
Pastor Reference Name

First NameLast Name
Pastor Reference Email
example@example.com
Pastor Reference Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Pastor Relationship
Character Reference 1
Character Reference 1 Name

First NameLast Name
Character Reference 1 Email
example@example.com
Character Reference 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Character Reference 1 Relationship
Character Reference 2
Character Reference 2 Name

First NameLast Name
Character Reference 2 Email
example@example.com
Character Reference 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Character Reference 2 Relationship
I willingly waive my right of access to see this confidential reference understanding that signing this waiver is not required as a condition of employment.
Should be Empty:

Lost Valley Staff Application Form

Basic Information

Camp Experience

Prior Employment History

Drug History

Additional Questions Required by the State of Michigan

Interest

References

Pastor Reference

Character Reference 1

Character Reference 2