STAFF APPLICATION. Personal Contact Information (Please Print) Name (First, Last) Male Female Age at camp this summer: Birth date / / Street / Box

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Camp Bennett 2017 STAFF APPLICATION CAMP BENNETT A MINISTRY OF CENTRAL UNION MISSION 20501 Georgia Ave. Brookeville, MD 20833 Phone: 202-437-5643 www.campbennett.org Kevin Hollowell, Camp Director Personal Contact Information (Please Print) Name (First, Last) Male Female Age at camp this summer: Birth date / / Marital Status: Single/Married Social Security #: Home Address: Street / Box City State Zip College Address: Street / Box City State Zip E-Mail Address (please write clearly): Phone: ( ) If you are not available from June 20 to August 12, please explain why Position Desired: Sr. Counselor Jr. Counselor Floating Counselor Arts and Crafts Camp Program Director Ropes Course Nurse Lifeguard 1

Have you attended or served at Camp Bennett in the past? When and in what capacity? Other camping experience: Awards and Certifications: (Note expiration dates on ARC, NSC and NRA) National Safety Council Wilderness first Aid American Red Cross CPR for Professional Rescuer Life Guarding Advanced Life Saving LPN or RN Other Specific Camping/Recreational skills you can teach: _ Some information about you What is your church home, and what is your participation there? Have you ever been hospitalized or has it been recommended for physical/emotional reasons? Do you have physical/emotional limitations or problems (please include any allergies)? Yes No Yes No If you answer is yes to either of the above two questions, please explain: What do you feel campers should gain from their Camp Bennett experience? What do you feel you should gain from your summer at Camp Bennett? Please describe how one becomes a Christian, and give at least three Bible references with your answer - don t be vague! (If you need more room to answer any question, please do so on the back of this application.) 2

What role does God play in your life? How can you see God working in your life? From your perspective, what is the Bible? Why do you want to work at Camp Bennett? References Please list three adult references below. Do not use family, relatives, or Central Union Mission/Camp Bennett employees. If you are not (or have not) been employed in the past, please supply a third reference from your church. Your Pastor (or ministry leader) Mailing Address Phone # An Adult Christian Brother or Sister Mailing Address Phone # Current/most recent Employer Mailing Address Phone # Below, please list the date and situation for any traffic or criminal convictions against you, including any pending court actions. Please note that we conduct criminal background checks on applicants 18 or older. Driver s License # State: Have you ever been subject to school discipline? If yes, please describe: 3

Please put your initials in each blank if you are in agreement with the statement. I agree to abstain from alcohol, drugs, smoking, using foul and inappropriate language, sexual activity, sexual conversations/harassment/pornography, bullying or other activities contrary to the Bible, the expressed word of God. Any violation could result in immediate termination as a staff member of Camp Bennett. Rumors, backbiting, and unresolved interpersonal issues soon tear apart the people of God. Matthew 18: 15-17 is clear about how to handle disagreements, misunderstandings and troubled feelings. Do you agree to talk only with the person/persons who have offended you about the offense, and not talk to anyone else about the offense until you have worked through the problem in the proper biblical steps? Do you agree to welcome a person that you have offended who comes directly to you to resolve the issue, and if the issue in not resolved, proceed through this biblical process? I understand that the Camp Director and camp leadership is are in place to provide a safe and nurturing environment for campers and staff, as well providing smooth camp operations. I agree without hesitation to abide by all camp rules and the leadership of the senior camp staff. Central Union Mission Statement of Faith We hold the Bible to be God s Holy Word in its entirety. It is inspired in every part by the Holy Spirit (II Timothy 3:16, II Peter 1:21). We hold that man was created in the image of God, holy and innocent; that of his own choice, he sinned, and as a result, brought death upon all humanity (Romans 3:23, 5:12, 6:23). We hold that Jesus Christ is God, born of a virgin, that He gave His life on the cross where He, who knew no sin, was made sin for us; that He was buried and rose from the dead and afterward ascended into Heaven, from whence He will come again (John 5:39, II Corinthians 5:21, I Corinthians 15:4, Acts 2:9-11). We hold that we are saved by grace through faith, apart from works; that the sinner who repents and personally accepts the finished work of Christ on the cross, becomes a child of God; is made a new creature and is indwelt by the Holy Spirit (Ephesians 2:8-9, John 1:12, II Corinthians 5:17, John 14:17). We hold that Jesus is coming again for His church, to establish His kingdom on earth, to judge the wicked and the lost, cast death and hell into the lake of fire, and dwell with the saints forever (John 14:3, Titus 1:13, I Thessalonians 5:16-17, Revelation 20:6, 15, 22:1-5). We hold that through preaching, teaching, and ministering, Central Union Mission must use its resources and activities to bring men, women, and children under the power of the Gospel; that they may have victory over sin, come into fellowship with God and live Spirit-filled, fruitful lives in Christ. I am in agreement with the above Statement of Faith, except as noted here: 4

By signing below, I believe my responses in this application are a fair and clear statement of my situation, feelings, and beliefs at the present time and that I believe I am fitted for service at Camp Bennett in the position applied for. Signature: Date: If under the age of 18, please have parent or legal guardian sign below. I have read this application. I affirm the truthfulness of answers given to the best of my knowledge, and I understand what is expected of my above-mentioned dependent at Camp Bennett. Printed Name/relationship to applicant Signature Date Please send application to: Kevin Hollowell, Camp Bennett, 20501 Georgia Avenue, Brookeville, MD 20833 Email: khollowell@missiondc.org Phone: (202) 437-5643 Website: www.campbennett.org 5