Summer Staff Applicants must be out of high school by June 2014, be a communicant member of a Christian Church, be actively developing a mature Christian faith, love children and youth, communicate well, be willing to do whatever benefits Aldersgate Camp & Retreat Center and its summer program, and be available from May 19 through July 27, 2014.
Circle the 3 positions for which you are qualified and which you would accept if offered a position. Place a (1) next to the position you want the most. A (2) next to your second option and a (3) next to your third choice:
Summer Program DirectorFirst Aid Outdoor Activity DirectorCounselor
*Life Guard Animal Activities DirectorCreation SensationMaintenance
KitchenArts & Crafts
*Must be a Red Cross Certified Lifeguard
Age group prefer to work with:
Inter-GenerationalLower Elementary Upper Elementary Middle School Sr. High
PERSONAL INFORMATION:
Name______Preferred to be called ______
LastFirst Middle Initial
S.S. #______Birthdate (optional) ______
Permanent Address______Phone ______
______E-mail ______
Current Address______Phone ______
(If Different)
______E-mail ______
Until when?______
EDUCATION:
Grade or School Level that will complete as of June 2014 ______School______
Major______Address______
Other Colleges or Universities you have attended ______
CHURCH AFFILIATION: Church Name ______Denomination ______
Minister's name ______Address ______
(Minister you know best)
City ______State ______Zip ______
How often do you attend worship? ______What leadership roles, if any, have you held? ______
______
CAMP EXPERIENCE: List your experience in camps - designate your role for each (camper, counselor, lifeguard, etc.)
CAMP & STATE______ROLE DATES _____
______
______
______
List your experience working with children and youth: What age groups and where? ______
______
______
______
CAMP ACTIVITIES, INTERESTS AND SPECIAL QUALIFICATIONS:
Do you have a valid driver's license? ______If yes, then.... State ______Number ______
Do you have a current Commercial Drivers License? ______
Please indicate areas in which you have training - include certification, date, agency, and copy of certification:
Lifeguard ______Water Safety Instructor ______
CPR (Child & Infant) ______CPR (Adult) ______
First Aid ______EMT ______
Canoeing ______Low Ropes Course ______
High Ropes Course ______Climbing/Rappelling ______
Zip-Lining______
In the following list put a (1) by the activities you can LEAD or TEACH and a (2 ) by the activities in which you can ASSIST.
WORSHIP/BIBLE ACTIVITIESARTS & CRAFTSMUSIC
___Leading Bible studies___Sketching___Guitar
___Leading discussions___Painting___Piano
___Devotions___Jewelry/beadwork___Lead Singing
___Worship planning___Nature Crafts___Other
___Worship leadership___Pottery
OUTDOOR LIVING SKILLSNATURE SKILLSAQUATICS
___Overnight Camping___Animals___Swimming
___Wilderness Camping___Forestry___Water games
___Outdoor cooking___Plants/flowers___Canoeing
___Backpacking/hiking___Rocks/minerals___Kayaking
___Climbing/rappelling___Fossils___Sailing
___Initiative Games___Astronomy
___Low initiatives (ropes)___Weather
OTHER
____High Ropes___Zip-Lining___Sports___Drama___Noncompetitive Games
____Small Group Leadership ___Spelunking/caving___Archery___Mission
____Skits ___Sports___Gardening___Story Telling
WORK HISTORY:
Please list your 3 most recent employers, city and phone number, type of work and dates employed (start with most recent):
1)______
2)______
3)______
REFERENCES:
Please give the enclosed reference forms to at least 3 people who are not related to you who will act as a reference for you. It would be helpful for you to put your name by the space marked "RE:" Sign the release form and indicate if you are willing to waive your right to see your reference forms. These people should be knowledgeable not only about your character, but should know your qualifications for the positions for which you are applying. We would prefer for one of them to be your pastor, church educator, youth leader or another person from your church. These forms should be mailed directly to Aldersgate Camp & Retreat Center to the address on the form. These are required for employment.
Please list below the names, addresses and phone numbers of the persons you ask to be a reference for you.
NAME______ADDRESSPHONE NUMBER RELATIONSHIP____
1) ______
2) ______
3) ______
ESSAY QUESTIONS:
Please fill out this essay page. (Feel free to use additional pages, if needed when filling out this page).
1) Please state why you wish to serve at Aldersgate Camp & Retreat Center. What contributions can you make?
2) You will be a leader in a summer staff role. What is your style of leadership and what do you feel makes a good leader?
3) Who is Jesus Christ and what would you tell an Elementary Camper is the most important part of your relationship with Him?
4) How would you share with a Middle School Camper how you put your faith and relationship with God into daily living practice?
5) What is a way that you have been put into a servant role over the past year?
6) Briefly describe one experience that has contributed to a recent growth in your Christian Faith.
What is the earliest date you are available? ______
PERSONAL QUESTIONS:
Are there any physical, emotional, social or academic factors we should know which might prevent you from completing the summer and/or living up to our expectations for summer staff? ______If yes, please explain.
______
______
Have you ever been convicted of a felony or misdemeanor? ______If yes, please provide additional details including date, place, lawyer's name, charge, etc.
______
______
Have you ever been the subject of an investigation by the Department of Family and Children Services or comparable government entity for abuse of any kind, including child abuse, sexual abuse, etc.? ______If yes, please provide additional information including date, county and state of investigation, etc.
______
______
Have you ever been treated or hospitalized for alcohol or substance abuse, an emotional disorder, or psychiatric illness? ______If yes, please provide additional information including dates of treatment, place(s) of treatment and doctor's name(s), etc.
______
______
______
In submitting this application, I understand that a satisfactory personal interview is a prerequisite to being accepted for the position for which I am applying.
I hereby authorize, by my signature below, The Kentucky Conference of the United Methodist Church, Aldersgate Camp & Retreat Center, its agents and employees to contact for verification any and all references, employers, law enforcement agencies, doctors and health care providers and so specifically release the The Kentucky Conference of the United Methodist Church and Aldersgate Camp and Retreat Center, of any and all claims arising from such inquiries or contacts, and further release any and all persons and entities from any claim arising from their responding to such inquiries or contacts.
By my signature, I verify that all information on this application is true to the best of my knowledge and understand that any falsification on my part is grounds for not being hired or termination of employment with Aldersgate Camp & Retreat Center.
Signature ______Date: ______
Please complete this form ASAP! and return it to:
Dave Cohn, Aldersgate Camp & Retreat Center
125 Aldersgate Camp Rd. Ravenna, KY 40472
For more information call 606-723-5078
All statements become part of any future employee’s personnel file.