Wufoo

Returning Summer Staff Application

Tell us all about you!

Name * First Last
Birthdate MM / DD / YYYY
Age
Current Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Please list your current mailing address
Home Phone ### - ### - ####
Cell Phone ### - ### - ####
Email *

Please list the email that you check the most often
Drivers License *
Yes No
Citizenship *

What country are you a citizen of?
Gender
Male Female
Marital Status *
Single Married
T-shirt Size
Type of Service

Which position are you applying for? Please rank choices in order of what position you prefer.
First Choice
Second Choice
Availability

What dates are you available this summer?
Available to Start: * MM / DD / YYYY
When is the first day you could arrive at camp?
Most of our positions start with staff training on June 11th.
We also have an Advanced Crew option beginning June 4th.
If you are applying for the Adventure Guide position, Guide Training starts May 25th and is required.
Need to Leave By: * MM / DD / YYYY
When do you need to leave camp?
We ask for our staff to stay through August 16th, when camp officially ends.
We do have some half summer options if you can't commit to the whole summer.
Church Information

Please list your church information here.
Current Church

What church are you currently attending?
City

Where is your current church located?
Phone ### - ### - ####
What's the phone number for your current church?
How often do you attend church?
Pastor's Name

What is the name of the pastor at your current church?
Youth Pastor/College Pastor's Name

What is the name of the pastor or leader for your youth group, or student ministry program?
Work Phone ### - ### - ####
What is the phone number for your Youth Pastor/College Pastor?
Purpose
Describe briefly your reasons for wanting to return to Grove/Discovery Outfitters this summer.
Do you have any experience or hold any current certifications in these areas?
Current First Aid Certification Current CPR Certification Current Lifeguard Certification
Other

Do you have any other certifications that we should know of?
Work Experience

Please list any jobs you have held since working for Canby Grove/Discovery Outfitters last.
Employer One

List your most recent employer.
Position, Duties and Dates

Please list the position you held for this employer, your duties, and the dates you were employed.
Supervisor

Who was your direct supervisor for this employer?
Supervisor Phone Number ### - ### - ####
What is the phone number for your Youth Pastor/College Pastor?
Education Experience
What is the current school you are attending and degree you are pursuing?
What are your career/occupational goals?
Digging a Little Deeper
In what areas are you trying to improve right now?
Please describe any significant experiences or difficulties that you have faced over the past year that you feel we should know about.
Describe any leadership training you have received.
Christian Life and Ministry
How do you know that you have been growing in your faith in the past year?
Describe your commitment to spiritual disciplines (devotions, worship, witness, fellowship, etc) in the past year.
Remind Us...
Describe one strength.
Describe one weakness.
What life experiences have been most significant in shaping you as a person, in the last year?
Christian Experience
Who is Jesus Christ to you? Describe your relationship to Him as it stands today.
Describe your commitment to the church and to fellowship with other believers.
Please list your experience with any para-church ministries you've been involved with in the past year. Also feel free to include volunteer community involvement.
Medical and Confidential Information
As a Canby Grove/Discovery Outfitters Summer Staff member, you may be required to do large amounts of physical work as an Adventure GUide, including, but not limited to things such as driving long distances, lifting and carrying rafts, carrying large coolers and other kitchen equipment (50-75 lbs), swimming through swift waters, lifting people from the water, hiking steep ridges, loading boats and other heavy lifting. Do you believe that you will be able to perform these duties? *
Yes No
If no, please explain:
Are you currently using medication? *
Yes No
If yes, please specify what and why:
Do you use illegal drugs? *
Yes No
Have you ever been convicted of a criminal offense or of child abuse or neglect?
Yes No
If yes, please explain:
Has your driver's license ever been suspended or revoked?
Yes No
If yes, please explain:
Other than the above, is there any reason that would call into question your being entrusted with the supervision, guidance, and care of young people?
Yes No
If yes, please explain:
Summer Staff Team Commitment

I understand as a Summer Staff member I agree as follows:
1. I will support in good spirit the ministry of Canby Grove/Discovery Outfitters.
2. I will welcome instruction and seek to benefit from it.
3. I will seek to be a good example and a strong Christian witness to all campers and staff.
4. I will be willing to perform ordinary tasks with a servant's heart.
5. I will be willing to go above and beyond the call of duty to the betterment of the camp program and myself.
6. If I am offered a position and accept it, I will honor my commitment.
7. I will seek to be a positive contributing member of the staff team, helping to build unity and support each fellow staff member,
8. I will abide by Canby Grove/Discovery Outfitters policies and support the mission, goals and core values of Canby Grove. I affrm that I will read any Canby Grove/Discovery Outfitter provided material and become familiar with its contents prior to my arrival at Canby Grove.
References

Please provide the names of thwo people at least 20 years of age who know you well and have agreed to act as your references. At least one should be a Christian worker (Pastor, Youth Pastor, Christian group leader, etc). Please do not use relatives. Indicate if the phone number is a home or work number. It is your responsibility to make sure they send the reference form supplied directly to Canby Grove.

You will be emailed reference forms once you are finished with this applcation.

Please include NAME, RELATIONSHIP, and PHONE
Reference One *

Name, relationship and phone
Reference Two *

Name, relationship and phone
Agreement

It is understood and agreed upon that any misrepresentation by me on this application will be sufficient cause for cancellation of this application and/or separation from the employer's service if I have been employed. The typing of my name is done prayerfully and with the understanding that its fulfillment is done to the glory of Jesus Christ.

I give the employer the right to investigate all references and to secure additional information about me, if job-related. I hereby release fro liability the employer and its representatives for seeking such information and all other persons corporations or organizations for furnishing such information.

I agree to the Summer Staff Team Commitment listed above.
Please type your name for an online signature: *

Please type your name as a legal online signature attesting that you have read the above release and commitment.
Do Not Fill This Out
Do Not Fill This Out

Wufoo

Returning Summer Staff Application

Type of Service

Availability

Church Information

Purpose

Work Experience

Education Experience

Digging a Little Deeper

Christian Life and Ministry

Remind Us...

Christian Experience

Medical and Confidential Information

Summer Staff Team Commitment

References

Agreement