Name
*
First Name
Last Name
Middle Name
*
Birth Date
*
MM
DD
YYYY
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
(###)
###
####
Email
Driver's License No:
Social Security No:
Are you a citizen of the United States?
If no, are you authorized to work in the U.S.?
Have you ever worked for this company?
If yes, when?
Have you ever been convicted of a felony?
If yes, explain
Did you graduate
Did you graduate?
Degree
Name
First Name
Last Name
Phone
(###)
###
####
Relationship
Name
First Name
Last Name
Phone
(###)
###
####
Relationship
Company
Phone
(###)
###
####
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Supervisor
Job Title
Responsiblities
Start Date - End Date
Reason for leaving
Company
Phone
(###)
###
####
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Supervisor
Job Title
Responsibilities
Start Date to End Date
Reason for Leaving
Company
Phone
(###)
###
####
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Supervisor
Job Title
Responsibilities
Start Date to End Date
Reason for Leaving
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
*
Which age group do you prefer to work with? Please select one.
Please describe why you are interested in becoming a Camp Counselor.
As a Camp Counselor, this summer, list some goals you hope to accomplish.
List some experiences that you have had that have prepared you to be a Camp Counselor, including prior experience with New Destiny Xtreme Kids Camp. i.e., babysitting, school clubs, extracurricular activities, etc.
As a camp employee, you will be required to participate in daily physical activities. Do you have any health concerns that would prevent your participation? Explain
Have you been a regular communicant at Christ Worship Center or any other church during the past year?
In two sentences or more please describe your relationship with Christ.
The following is a list of camp activities you may encounter as a camp employee. Please select any activity you would feel comfortable instructing.
You may select more than one.
