Lake Swan Staff Application

General Information:

Name:_______________________________________________________________

Mailing Information:		Street:_______________________________________

			City:_________________________________________

			State:_______________________zip:______________

			Phone:_______________________________________

			E-mail:_______________________________________

Permenant Address: 	Street:_______________________________________

			City:_________________________________________

			State:_______________________zip:______________

			Phone:_______________________________________

Social Security Number:	____________________________________________

Marital Status: (circle one) 	Married 	Single

Date of Birth:		_____________________

Driver's License No: 	____________________________________________
		
		circle all that apply:	learner	operator	chauffeur

In Case of Emergency Please Notify:	____________________________________

		     Phone:		____________________________________

Do you smoke? ______	Do you drink?______	Use Narcotics?________

Have you ever been convicted of a criminal offense?   Yes   No  

Have you ever been convicted of child abuse or a crime involving actual or attempted sexual molestation of a minor?	Yes	No

If Yes, please explain:_____________________________________________________

Name and Denomination of Church:__________________________________________
Member?    Yes	No

How did you learn about Lake Swan Camp?____________________________________

List any physical problems or physical limitations. Include allergies and medications currently taken.

______________________________________________________________________



Educational Background:


High School:__________________________________ Year Completed: 10    11    12

College/University:_____________________________   Year Completed: 1    2   3   4

Other Training:___________________________________________________________

_______________________________________________________________________


Employment Record:


Name of Employer			Address		Position		When

_______________________________ ________________ ________________ ___________

_______________________________ ________________ ________________ ___________

_______________________________ ________________ ________________ ___________

_______________________________ ________________ ________________ ___________



References:
Do not list high school students or relatives.

Pastor/Youth Pastor:_____________________________________________

Telephone:____________________________________________________


Employer_____________________________________________________

Telephone_____________________________________________________


Friend________________________________________________________

Telephone_____________________________________________________


What positions in camp do you prefer (please check and indicate your top 4)

_____kitchen	_____Grounds	_____Hostess	_____Office

_____Waterfront	_____Housekeeping	_____Snack Shack

_____Maintenance

In which of the following areas do you have experience? 
Please mark (1) if you have SOME experience, (2) if you feel COMFORTABLE doing it, (3) if you could ASSIST TEACHING it,
(4) if you have been CERTIFIED in it (state what level of certification and by whom):


_____Canoeing		_____Boat Driving	

_____Filing		_____Swimming

_____Sound		_____Life Guard

_____Lawn Care		_____Music

_____Water Skiing		_____Maintenance

_____Typing		_____Other - specify:_______________________________


On what date would you be available?__________________________________

For how long can you stay?__________________________________________

Do you plan to take and certificate courses this year? (ie: Red Cross, etc)

_______________________________________________________________________

Would you be willing to take any certificate courses if offered? ________________________

Other course training that you have had?_________________________________________


Personal Information:
On a seperate sheet of paper, please answer the following questions:

1. Describe how a person can receive eternal life.
2. Describe your own personal experience in receiving eternal life.
3. Summarize your recent involvement in Church, Para-Church or Youth Organization.
4. What is the purpose of Christian Camps?
5. State briefly why you would like to work at Lake Swan Camp.
6. Give any othe rinformation that you think would be helpful such as training, etc.


Applicant's Statement

The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my charater and fitness for working with children, youth, or camp ministry. I release all such references from any liability for furnishing such evaluations to you, provided they do so in good faith and without malice. I waive any right that I may have to inspect references provided on my behalf. Should my application be accepted, I agree to be bounded by the bylaws and policies of Lake Swan Camp and to refrain from any unscriptural conduct in the performance of my services. I will assist to the best of my ability in maintaining and further developing the high ideals, Christian emphasis, and service requirements of this camp.

Applicant's Signature: ____________________________________ Date:________________

Parental/Guardian Signature _______________________________ Date:________________