2019 Summer Staff Application

Name*
First Last
Gender*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Age*
Please enter a number from 17 to 100.
Date of Birth*
Date Format: MM slash DD slash YYYY
Phone Number*
School Address (If Applicable)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Social Security Number (***-***-****)*
Drivers License Number (If Available)
Home Church Name
Church Phone Number
Church Pastor's Name
First Last
Church Name (If away for school and applicable)
Church Phone Number
Church Pastor's Name
First Last
What church activities/ministries are you involved in?
High School Attended*
Date of HS graduation*
Date Format: MM slash DD slash YYYY
College Attended/Attending (If Applicable)
Year in College (If Applicable)
Major/Degree in College (If Applicable)
Date of College graduation (If Applicable)
Date Format: MM slash DD slash YYYY
Name of Pastoral Reference*
First Last
Phone Number of Pastoral Reference*
Address of Pastoral Reference*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email of Pastoral Reference*
Name of Other Reference*
First Last
Other Reference's Relationship To You*
Phone of Other Reference*
Address of Other Reference*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email of Other Reference*
Emergency Contact Name*
First Last
Emergency Contact Relationship To You*
Emergency Contact Phone Number*
Emergency Contact Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
2nd Emergency Contact Name*
First Last
2nd Emergency Contact Relationship To You*
2nd Emergency Contact Phone Number*
2nd Emergency Contact Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Most Recent Employer Company Name*
Most Recent Employer Phone Number*
Most Recent Supervisor's Name*
First Last
Most Recent Job Title*
Duties Preformed*
Reason for Leaving Most Recent Job (If Applicable)
Date Beginning Employment*
Date Format: MM slash DD slash YYYY
Date Employment Ended (If Applicable)
Date Format: MM slash DD slash YYYY
Another Employer Company Name
Employer's Phone Number
Supervisor's Name
First Last
Job Title
Duties Performed
Reason for Leaving (If Applicable)
Date Beginning Employment
Date Format: MM slash DD slash YYYY
Date Ending Employment (If Applicable)
Date Format: MM slash DD slash YYYY
Personal Evaluation Portion*
Please enter a number from 1 to 5.
Please type in the appropriate number (scale of 1-5) for how you would rate yourself in the following areas listed with 1 being the lowest and 5 being the highest. Please select 5 for this question if you understand what is expected from you for this portion.
Teachable*
Please enter a number from 1 to 5.
Promptness*
Please enter a number from 1 to 5.
Follows Instructions*
Please enter a number from 1 to 5.
Fulfills Obligations*
Please enter a number from 1 to 5.
Sense of Humor*
Please enter a number from 1 to 5.
Anger Management*
Please enter a number from 1 to 5.
Enthusiasm*
Please enter a number from 1 to 5.
Trustworthiness*
Please enter a number from 1 to 5.
Cooperative*
Please enter a number from 1 to 5.
Tactful*
Please enter a number from 1 to 5.
Leadership*
Please enter a number from 1 to 5.
Friendliness*
Please enter a number from 1 to 5.
Respect for Authority*
Please enter a number from 1 to 5.
Work Ethic*
Please enter a number from 1 to 5.
Energy Level*
Please enter a number from 1 to 5.
Commitment*
Please enter a number from 1 to 5.
Spiritual Maturity*
Please enter a number from 1 to 5.
Personal Experience
Please select and then briefly explain your level of experience in the following areas using this scale: 0 – No experience or participation; 1 – Participated once or twice; 2 – Some experience; 3 – Experienced but still learning; 4 – Lots of knowledge and experience; 5 – Can lead and teach others in this area. Please leave this line blank.
Sharing your Testimony*
- 1
- 2
- 3
- 4
- 5
Briefly Explain*
Leading games, relays, sports, etc.*
- 1
- 2
- 3
- 4
- 5
Briefly Explain*
Interacting with Children (ages 4-12)*
- 1
- 2
- 3
- 4
- 5
Briefly Explain*
Interacting with Youth (13-18)*
- 1
- 2
- 3
- 4
- 5
Briefly Explain*
Leading Bible Studies*
- 1
- 2
- 3
- 4
- 5
Briefly Explain*
Working with High Ropes, a Climbing Walls, and Low Ropes*
- 1
- 2
- 3
- 4
- 5
Briefly Explain*
Do you play an instrument?*
If yes, what?*
Can you lead worship?*
Are you CPR certified?*
If yes, by whom? When does it expire?
Are you First Aid certified?*
If yes, by whom? When does it expire?
Are you Lifeguard certified?*
If yes, by whom? When does it expire?
List all and any other certifications here
Which 2019 Summer Staff Position are you interested in? (You may select more than one)*
Are you interested in a leadership opportunity (you may select more than one)?*
If you are applying for a position as an Area Manager or Program Staff, which do you prefer as your morning assignment focus?
If you are applying for a position as an Area Manager or Program Staff, which do you prefer as your afternoon assignment focus?
If you are applying for any position, do you have a desire to help in either of the following areas?*
Do you have any level of physical limitations? (loss of hearing, diabetes, asthma, epilepsy, etc.)*
If yes, please explain.
Have you ever had any problems in the past with physical limitations?*
If yes, please explain.
Do you consider yourself allergic to anything, including medication?*
If yes, please explain.
Are you currently taking any kind of medication (prescribed or other)?*
If yes, please explain.
Have you had any serious injuries or illnesses in the past that we need to be aware of?*
If yes, please explain.
Do you have health insurance?*
If yes, what is the company?
If yes, what is the policy number?
Have you ever attended a camp before?*
If yes, what was the name of the camp?
If yes, how many weeks in total have you attended said camp?
If yes, please provided the dates you attended said camp here.
Have you ever volunteered at a camp before?*
If yes, what was the name of the camp?
If yes, how many weeks in total did you volunteer at said camp?
If yes, please provided the dates you volunteered at said camp here.
If yes, please list your responsibilities while volunteering.
Have you ever been on paid staff at a camp before?*
If yes, what was the name of the camp?
If yes, how many weeks in total did you work at said camp?
If yes, please provided the dates you worked at said camp here.
If yes, please list your responsibilities while working.
Have you ever served in missions, or on a missions project?*
If yes, where and when?
If yes, what did you do?
Have you ever applied for a position or been hired in a position at Camp Marengo before?*
If yes, what position?
Why would you like to work at Camp Marengo?*
How do you feel you would contribute to the ministry of Camp Marengo?*
The following section is a preliminary background check. If you are hired you will be expected to fill out a government sanctioned background check as well. Please be honest with your answers. Write "yes" in this space if you understand.
Have you at ANY time EVER been arrested for any reason?*
If yes, explain
Have you at ANY time EVER been convicted of, or pleaded no contest to any crime?*
If yes, explain
Have you at ANY time EVER engaged in, or been accused of, any child molestation, exploitation, or abuse?*
If yes, explain
Have you at ANY time EVER been convicted of a felony?*
If yes, explain
Are you willing to submit to a background check?*
Spiritual Background
Please answer the following questions honestly. You will not be disqualified from a position because of a struggle in your faith or need for growth. We just want to know where you are at!
What does it mean to you to be Christ follower?*
How and when did you follow Christ? What lead you to make this decision?*
In what ways are you fulfilling your commitment to Christ and/or in what ways are you serving in other ministries?*
What activities, organizations, people, or events have been a significant part of your spiritual growth?*
Describe at least three qualities that you feel should be evident in a Christ Follower’s life?*
Describe at least three qualities in your own life that you think reflect your spirituality?*
What is evangelism? How are you currently sharing Christ with others?*
How would you help lead someone else to Christ? What would you say, verses would you use, etc.?*
What activities or organizations are you currently involved with to strengthen and mature your faith?*
Do you feel you are capable of performing the duties required of the Camp Marengo Staff?*
If you do not feel completely capable, what do you think would enable you to perform the duties of the Camp Marengo Staff?
Signature*
Thank you so much for taking the time to fill out this application. We hope you have spent some time praying about this decision and the ministry of Camp Marengo. You will be contacted about staff decisions. If you have any further questions, comments, or concerns please contact Bethanne Martin at (740)747-2325 or bethanne@campmarengo.com. By typing your name below, I affirm and acknowledge that the answers given by me throughout this application are complete and true to the best of my knowledge and belief. This acts as an electronic signature.
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Email: bethanne@campmarengo.com

Number: 740-747-2325

Address: 3480 221 Township Rd Marengo, OH 43334
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Camp Marengo

2019 Summer Staff Application

2019 Summer Staff Application

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