Staff Application 2008
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  Please complete and mail to the director with health form by March 1,2008. Make a copy for your records.

Name _____________________________________________________
            Last                                                             First                           MI

Address ____________________________________________________

____________________________________________________

E-mail address ___________________________ Phone (_____)_________

Birthdate _______________ Date of application ______________ T-shirt size___________

Name and address of the church you attend.
Church ________________________________________________
Address _______________________________________________
Phone number _______________  Pastor ________________________

In what way are you involved in the worship and/or ministry of your church or explain your involvement in any church related and religious activities?

 

 

Pastor's signature _________________________ My signature verifies that this person is involved in my church on a regular basis.

Please explain in a few words why you want to serve at Camp Luther.

 

 

I would like to serve in this capacity:

__Dean  __Counselor  __Chaplain  __Nurse  __Office Staff   __Teacher*

__Spiritual Director  __Webpage photographer  __Psychologist  __Director

 *Teacher areas:  __Bible __Catechism   __Camp Curriculum __Music  __Nature  __Crafts__Sports  __Newspaper  __Swimming  __Creative Arts

In which program would you like to serve?

___ Jr. Program (Grades 3-5) ___ Inter. Program (Grades 6-8) ___ Sen. Program (Grades 9-12)

Do you have certification in any of the following? ____ Life Saving ____ First Aid

Have you taken the training for “Safe Guarding God’s Children”?  ________________

Where and when? ______________________________________________________
_____________________________________________________________________

Please attach a copy of your certificate with this application.

 

What would be the greatest strength that you would share with the program at Camp Luther?

 



 

Please list three references. Please ask your references for permission to use their names. At least on reference should be a member of your church. Letters from two of the references will be required for new applicants. Please print.

Name                                                         Address                                                                        Phone

1. ______________________________________________________________________

2. ______________________________________________________________________

3. ______________________________________________________________________

 

Have you ever been discharged or forced to resign from employment or a volunteer role?
____no ____yes

If yes, please give the details, including the name of the employer or group.

 

Have you ever been convicted of a crime or are you under charges for any offense against the law, other than minor traffic violations? ____no ____ yes

If yes, please give the details. ________________________________________

_____________________________________________________________

_____________________________________________________________

CERTIFICATION (Please read this statement carefully before signing)

I hereby certify that my answers to the above questions are true, complete, and correct. I understand that false answers on this application may be grounds for immediate dismissal from Camp Luther. I also understand that the above answers are subject to verification.

Signature _______________________________________ Date _________

Due March 1, 2008

Please return this application and health form to :
Camp Luther
c/o Pat Schillings
1600 Kanawha Blvd. E.
Charleston, WV 25311