Name: Women on Mission Annual Retreat
Start: 2022-08-20T09:00:00-05:00
End: 2022-08-20T13:00:00-05:00
Location: Sixth Avenue Baptist Church

This application can be submitted online by advancing through the below form.

We recommend reviewing the PDF version here to be ready to complete each field.

You are also free to complete the PDF version if necessary and return to Sixth Avenue Baptist Church.

Camp Staff Application PDF

*Please note. You will be prompted to upload a copy of your driver’s license and certification documentation (if applicable).

Summer Camp Staff Application

Step 1 of 12

Applicant Information
Name*
First Last
Permanent Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Are you at least 16 years of age?*
Are you 25 years or older?*
T-Shirt Size*

Please Type S, M, L, XL, 2X, or 3X
Background Check Information
Social Security Number*
Driver's License Number and State Issued*
Date of Birth*
MM slash DD slash YYYY

Work History
Provide a full record of all employment — paid and volunteer — and explain any gaps in employment. Include any positions on camp staff.
Start Date
Month
Day
Year

Use day "01" if the exact date is unknown.
End Date
Month
Day
Year

Use day "01" if the exact date is unknown.
Company / Organization
Supervisor Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
Nature of Work
Reason for Leaving
Start Date
Month
Day
Year

Use day "01" if the exact date is unknown.
End Date
Month
Day
Year

Use day "01" if the exact date is unknown.
Company / Organization
Supervisor Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
Nature of Work
Reason for Leaving
Start Date
Month
Day
Year

Use day "01" if the exact date is unknown.
End Date
Month
Day
Year

Use day "01" if the exact date is unknown.
Company / Organization
Supervisor Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
Nature of Work
Reason for Leaving

References
Give names of three people [not relatives] having knowledge of your character, experience, work habits, and ability.
Name*
First Last
Phone*
Relationship To You*
Name*
First Last
Phone*
Relationship To You*
Name*
First Last
Phone*
Relationship To You*

CAMP OR TEACHING EXPERIENCE
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Camp or School
Location
Position Held
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Camp or School
Location
Position Held
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Camp or School
Location
Position Held

Education
Years
School
Major Subjects
Degree Granted
Years
School
Major Subjects
Degree Granted
Years
School
Major Subjects
Degree Granted

Please answer the following.
What contributions do you think you can make at camp?*
Tell us about a time you led and motivated a group of people.*

Criminal Record
Have you ever been convicted of a crime, other than a minor traffic offense?*
If yes, please describe. (Note: a prior conviction is not an automatic bar to employment. The type of conviction and when it occurred will be evaluated by the camp before any decision is made.)

Signature
I authorize investigation of all statements herein, including any checks of criminal records, and release the camp and all others from liability in connection with same. I understand that any agreement must be in writing and signed by the designated camp official. I also understand that misrepresentations or falsifications herein or in other documents completed or submitted by the applicant will result in dismissal, regardless of the date of discovery by the camp.
Signature*
Date*
MM slash DD slash YYYY
Please upload a clear copy of your driver's license.
Drop files here or

Max. file size: 128 MB.
Certification Documentation
Drop files here or

Max. file size: 128 MB.
Please upload any available certification documentation from any chosen certified skills above. (If not available at the time of submitting the application, can be provided at a later date.)

Summer Camp Staff Application

Summer Camp Staff Application

Step 1 of 12

Applicant Information

Background Check Information

Camp Work Information

Work History

References

CAMP OR TEACHING EXPERIENCE

Education

Please answer the following.

Camp Skills - Organize and Teach

Camp Skills - Assist

Camp Skills - Certified

CERTIFICATIONS AND CAMP SUPPORT STAFF SKILLS

Criminal Record

Signature

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