Whitewater Christian Service Camp Staff Application 9181 Whitewater Camp Road, Vevay, Indiana 47043 wcsc@whitewatercamp.org www.whitewatercamp.org Phone: (812) 534-3020 PERSONAL INFORMATION Please complete the following information: Name: Date: Have you ever used any other name(s)? If yes, please list: Applying for: Junior Staff Nurse Lifeguard Cook Birth date: Age: Do you have a valid Driver s License? Email: Cell: ( ) Home Phone: ( ) Permanent Address: Current College Address: Can you, upon employment, submit verification of your legal right to work in the US? Y Marital Status: Single Engaged Married Divorced Separated Widow T-Shirt Size: Small Medium Large XL 2 XL 3 XL Name of Parents (If under 18) : Home Church: Pastor s Name: Church Address: Are you a member of your church? How often do you attend? Do you agree with your church? If no, please explain: N EDUCATION AND TRAINING Please list your last 3 schools or colleges, with the most recent first: Name of School Years Completed Field of Study/ Major Degree/ Certificate 1. 2. 3. EMPLOYMENT HISTORY Have you been previously employed or volunteered at Whitewater Christian Service Camp? If yes, please list position and dates: 1
Current Employer (Not necessary if applying for junior staff): Company Name: Dates Employed: Company Phone: Supervisor Name: Job Title: Reason for Leaving: Address: City: State: Zip: REFERENCES Please list 3 personal (not related) references that have knowledge of your character, experience and abilities. Name How does this person know you? Phone Number 1. ( ) 2. ( ) 3. ( ) NOTE: It is your responsibility to give reference forms and addressed/ stamped envelopes to your references listed above. Your application is not complete and will not be processed until all reference forms have been received. Please include a Pastoral reference. OTHER INFORMATION 1. Have you been involved in an inappropriate physical relationship within the past 12 months? 2. Have you used tobacco or alcohol in the past 12 months? 3. Have you used any drug illegally in the 12 months? 4. Have you been involved in pornography in the past 12 months? 5. Have you been involved in gossip in the last 12 moths? 6. Have you ever been convicted of child abuse/ another crime? If you answered Yes to any question 1-6, please explain: 7. Profile your character using three positive and three negative adjectives: Positive: Negative: 8. Your relationship with your father is/ was: Cold Casual Warm Terrific NA 9. Your relationship with your mother is/ was: Cold Casual Warm Terrific NA 10. Do you have any previous or existing medical or psychological conditions that may affect your ability to perform your assigned task at WCSC? If yes, please specify: 11. When under pressure, you normally react by Please provide a specific example: 12. Who is the most influential person in your life? Why? 2
13. Do you believe the Bible teaches: One true, triune God? The inerrancy of Scripture? The urgency of all to be saved? The command for all believers to be baptized? The importance of local church membership? The six-day creation of the world by God? The virgin birth of Christ? The eternal security of the believer? 14. Do you feel there is anything that may keep you from meeting the expectations of the position you are applying for? If so, what would hinder you? 15. Please indicate any special training or certifications you hold: Water Safety Lifeguard First Aid CPR Archery Other 16. Please describe any other skills that may have a bearing on the position(s) for which you are applying. 17. Have you ever been convicted of any crime? If yes, please specify: 18. Please briefly describe your testimony of Salvation, current Christian growth and Christian service. 19. When was the last time you spoke with someone about Christ? Please give details about the conversation. 20. Please explain your plan to grow spiritually. 21. What do you expect to give and receive from your experience as a staff member at WCSC? 22. What positive contributions can you make at WCSC? 23. What are your current church/ministry activities? 24. What are your interests and hobbies? 3
25. If applying for a paid position, are you available for the entire summer (June 9 th July 26 th )? If no, please give specific dates & reason: 26. If applying for a junior staff position, please give the specific dates you are available: 27. Please attach a recent photograph of yourself to your application. 4
APPLICANT CERTIFICATION PLEASE READ CARFULLY AND SIGN I warrant that the facts set forth above are true and complete. I understand that if I am employed, falsification of this application (including falsification by omission or supplying misleading information) may result in dimissal regardless of when such falsification is discovered. I authorize Whitewater Christian Service Camp to investigate all information contained in this application. I authorize prior employers to give Whitewater Christian Service Camp any and all information concerning my previous employment and any pertinent information that they may have. I release all parties from any and all liability for any damage or injury that may result from furnishing the same to Whitewater Christian Service Camp. Sign: Date: If I am employed by Whitewater Christian Service Camp, I agree to conform to the rules and policies of Whitewater Christian Service Camp. I also understand and agree that while employed, my hours, working conditions, job assignment(s), and compensation rate(s) are subject to change by Whitewater Christian Service Camp. Sign: Date: If capable, please return this application via email or mail to the address listed at the beginning of this document. 5