LUTHERAN ISLAND CAMP AND RETREAT CENTER

45011230thStreetPhone:(218)583-2905

Henning,Minnesota56551Fax:(218)583-2906

E-mail:ebsite:

TEEN SERVANT AND/OR JUNIOR COUNSELOR APPLICATION SUMMER 2018

Application Deadline: April 1, 2018

Many young people would like to serve at Lutheran Island Camp as a volunteer. The first step is submitting this application to Program Director Louis Blocker. He will contact you within a week to set up a phone interview. After interviewing, you can sign up for one of the training sessions to be offered this spring and summer. All JCs must attend one of these sessions, regardless of prior experience. Teen Servants have several options they can choose including work with horses, maintenance, kitchen work, and serving as a junior counselor. A detailed description of each is available at our website. Please indicate which your preference is. You may select more than one:

Servant Options (please circle desired option): Program:JuniorCounselor(JC)Outreach(0R)

WithaTask:Horse OutreachProgram(HOP)Maintenance/Lawn(ML)Water Front(WF)

PERSONAL DATA

Name:CurrentPhone:

E-mail:Best time tocall:

HomeAddress:
Street / City / State / Zip

HomePhone:Birth date://

Month Day Year

MaleFemale

T-Shirt Size (so we can order staff t-shirts): S M L XL XXL XXXL

ChurchMembership:

NameofCongregationCity,State

Parents/Guardians:

NameName

Denomination:

ACADEMIC BACKGROUND
What school doyouattend?_
Name of School
Highest grade level completed (You must have completed the 10th grade in order to Serve Training Leadership and are 14 or older.):
SophomoreJuniorSenior
Do you have a high schooldiploma?YesNo / City, State
serve as a Teen Servant unless you have completedChrist
College Freshman
If yes, from where? / Name of School / City, State

PAST LUTHER ISLAND CAMPEXPERIENCE

THIS IS MY FIRST YEAR AT LUTHERAN ISLAND CAMP:

PAST JCTRAINING ATTENDED:CHRIST SERVETRAINING ATTENDED: YEARS SERVEDASJC: YEARS AT CAMP ASCAMPER:

ORGANIZATION ORCLUBMEMBERSHIPS:Please check ifcurrent

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□

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PAST EMPLOYMENT

List past two employers, beginning with the most recent. You may include volunteer church/community service.

Employer/BusinessAddressandPhonePosition Supervisor’sNameDate of Employment











Check all that apply:

PlayguitarPlaypianoCompleted firstaid/CPRtrainingCurrent lifeguard certification List any other abilities you have which would be helpful for your service atcamp:

REFERENCES

Please list two references (one reference being your pastor.)

NamePhonenumberE-mail (ifavailable)

1.

2.

Dates of Service: The sessions for the summer of 2018 are listed below. Fill out your preference in order—1 being your first choice, 5 being your last choice of which sessions you would be interested in serving at. We will try to the best of our ability to accommodate your preferences, depending on the staffing needs of Lutheran Island Camp.

#1.

#2.

#3.#4.

#5.

Applicant’sSignature:Date

Junior Servant Session Dates: Session 1: June 8-15; Session 2: June 15-22; Session 3: June 22-29; Session 4: July 6-13; Session 5: July 15-20*; Session 6: July 20-27; Session 7: July 27-August 3; Session 8: August 5-10* *NOTE: No weekend during these sessions.

You will be contacted within two weeks of reception to set up a phone interview.

Please return no later than April 1, 2018, to: Lutheran Island Camp & Retreat Center, 45011 230th St., Henning, MN 56551