Camp ACCOVAC
Tuesday, November 13, 2018
Explore... Rest...Heal...Grow

Staff Application

Camp ACCOVAC Staff Application:

Name:____________________________________________  Date of Birth: __________

Address:_______________________________________________________

Phone:__________________________  Email:________________________

Are you a United States citizen?  __ YES       __NO

If no, are you authorized to work in the U.S.?  ___YES    __NO

Have you ever worked at Camp ACCOVAC before?   __YES  __NO

If yes, when and what were your duties?__________________________________________________

___________________________________________________________________________________

Church you regularly attend: ________________________________________________

What involvement do you have? __________________________________________________________

Contact person at your church (name/phone or email):_________________________________________

 

Have you ever been charged with a crime? (excluding simple citations) __YES  __NO

If yes, below please give the nature of the incident, dates and list any charged filed against you:

 

 

 

 

Education:

High school attended: ________________________Did you graduate? __YES __NO

If no, why not? ______________________________________________________

 

 

 

List colleges/universities attended and any degrees earned:

College                                                                Dates                                       Degree/Subject Major

 

 

References:  Please list 3 non-family adults who can act as a reference to your character, and speak to your Christian faith, witness, and personality.

Name:___________________________________   Phone #:____________________

Email:________________________ Relationship to you:_______________________

Name:___________________________________   Phone #:____________________

Email:________________________ Relationship to you:_______________________

Name:___________________________________   Phone #:____________________

Email:________________________ Relationship to you:_______________________

Prior Employment

In the space below, please list former employment, starting with your most recent job. (last 5 years only). Include dates, responsibilities, and reason for leaving.

Employment:___________________________________Dates:_________________                                                             

Contact Person Name/Phone:_________________________________

Duties:_____________________________________________________________

Reason for leaving:___________________________________________________

Employment:___________________________________Dates:________________                                                             

Contact Person Name/Phone:_________________________________

Duties:_____________________________________________________________

Reason for leaving:___________________________________________________

Employment:___________________________________Dates:_________________                                                             

Contact Person Name/Phone:_________________________________

Duties:_____________________________________________________________

Reason for leaving:___________________________________________________

Employment:___________________________________Dates:_________________                                                               

Contact Person Name/Phone:_________________________________

Duties:_____________________________________________________________

Reason for leaving:___________________________________________________

 

 

 

Essay Questions: Please answer the following questions in detail.  Use additional pages if needed

Why do you want to serve on staff at Camp ACCOVAC?

 

 

 

 

How are you actively seeking to grow in your Christian faith?

 

 

 

 

 

What skills or abilities do you have that would be a benefit to Camp ACCOVAC’s ministry?

 

 

 

 

 

Please give a brief testimony:

 

 

 

 

 

 

DISCLAIMER: I recognize that Camp ACCOVAC is relying on the accuracy of the information in this application. Accordingly, I attest and affirm that all of the information that I have provided is absolutely true and correct.

I authorize Camp ACCOVAC to contact any person or entity listed in this application, and I further authorize any such person or entity to provide the organization with information, options, and impressions relating to my background or qualifications.

I voluntarily release Camp ACCOVAC and any such person or entity listed herein from liability involving the communication of information relating to my background or qualifications. I further authorize Camp ACCOVAC to conduct a criminal background investigation if such a check is deemed necessary and will provide my social security number to Camp ACCOVAC personnel if necessary.

I acknowledge that Camp ACCOVAC is a Christian ministry and commit that, upon joining the ACCOVAC staff, I will conduct myself in a manner consistent with Christian principles. My behavior and my attitudes will represent Camp ACCOVAC and Jesus Christ in a positive manner.

Signed: _______________________________________   Date: _________________________