STAFF APPLICATION PO Box 976 STANTON, TX Office:

Transcription

1 STAFF APPLICATION Please type or print clearly and return application to the address above. Social Security #: of Application: Driver s License #/State: City: State: Zip: Primary Phone #: Secondary Phone #: Birthday: Parent/Guardian s Relationship: Phone #: Parent/Guardian s Relationship: Phone #: Emergency Contact s Relationship: Phone #: Church Membership: Pastor: Church Phone #: Church City: State: Zip: Social Media Names: EDUCATION INFORMATION High School: City/State: Graduation: Colleges or Universities Attended Degree/Hours Completed s Attended Major: Minor: Special activities, athletics, or honors: List your participation in campus clubs and/or Christian organizations: EMPLOYMENT INFORMATION List current and/or two previous places of employment as well as any employer you DO NOT wish for us to contact, and why. Employer City/State Phone # s Position Reason for Leaving List work experience related to camp or missions. Include volunteer work as well as lifeguard or ropes course certifications. Camp/Mission City/State Phone # Director s Name Position/Responsibilities

2 How would you describe your ability to: Accept supervision? GENERAL INFORMATION Accept the restrictions of camp staff life? Work with your peers? Work with children? Each applicant must: Possess a lifestyle that demonstrates a genuine love for and faith in Jesus Christ. Be actively involved in a Baptist church, Baptist college, or college/high school student ministry program. Possess a passion to share the gospel with individuals in need of salvation. Possess a willingness to use your God-given gifts to serve as part of an evangelism team. HEALTH INFORMATION Do you have the ability to perform job-related functions such as lifting, carrying, walking and other medium to heavy labor? YES or NO Explain: If you have a disability or impairment, describe or demonstrate how with or without reasonable accommodations you would be able to perform job-related functions. List any allergies that may limit your ability to work at camp (outdoors, with food, housekeeping): Is there any reason, including those that are physical or mental health related that might affect your ability to work with, care for or supervise children? If so, please explain: List all medical information that may be pertinent to your employment: BACKGROUND INFORMATION Have you been accused or convicted of crime(s) other than traffic violations in the past 10 years? Explain: Have you ever been accused or convicted of a crime in which a child was the victim? Explain: Have you ever been criminally charged with any crime related to the mistreatment, abuse or molestation of children? Explain: Have you ever been accused of harassment of any person, including, but not limited to, sexual, racial, or religious? Explain: PERSONAL TESTIMONY Attach a brief, autobiographical testimony that includes: How and when you became a Christian and about your personal growth in your relation with Christ. What God is teaching you right now about where you need to be and what you need to be doing within the next year. How and why you feel that God is calling you to be a part of the Circle 6 Camp Team. What is your concept of missions and why do you want to serve in this capacity. What you feel are the important functions of a Christian camp and how would you be able to contribute to these functions.

3 REFERENCES Pastor Other Christian Leader (Youth Dir., Campus Min.) City: State: Zip: City: State: Zip: Phone #: Phone #: Present/Former Employer or Teacher Present/Former Employer or Teacher City: State: Zip: City: State: Zip: Phone #: Phone #: Adult Friend of Family Other City: State: Zip: City: State: Zip: Phone #: Phone #: I authorize Circle Six Baptist Camp (CSRBC) to obtain information from references, employers and churches listed herein. I also authorize any references, churches or other organizations or employers listed in this application to give CSRBC any information, including opinions that they may have regarding my character and fitness for the job I am applying. In consideration of the receipt and evaluation of this ap plication by CSRBC, I hereby release CSBC, any individual, church, children s organization, charity, employer, reference, or any other person or organization, both collectively and individually, from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. Should my application be accepted, I a gree to be bound by the bylaws and policies of CSBC, which are adapted from time to time, and to refrain from unscriptural conduct in the performance of my services on behalf of CSBC. I understand that CSBC desires to protect its guests and visitors and therefore give my permission for CSBC leadership to conduct a criminal background check on me and to maintain my fingerprints and photo ID on file. I further state that I have carefully read the foregoing release and know the contents thereof; and sign this release as my own free act. I understand that any misrepresentation or omission of a material fact on my application may be justification for refusal of employment or release from employment at any time. AUTHORIZATION In the event I am employed, I understand that all employees are subject to termination at the discretion of CSBC. If, in the event I choose to voluntarily terminate my employment, I am free to do so at any time, and if I choose to give proper notice of termination, CSBC may either permit me to continue my employment during the notice period or may accept my resignation immediately. I understand that, in the event I am employed by CSBC, my compensation (if any), hours of service and all other terms and conditions of employment are subject to modifi cation or change by CSBC at CSBC s discretion. Signature Parent/Guardian's Signature (If a minor) Signature is required to complete the application. Application will be valid for 90 days. If no decision is made by the camp as to employment within 90 days, another application should be completed and submitted if employment is still desired.

4 STAFF REFERRAL Circle 6 Ranch is a Christian camp for children, youth and adults. Please answer the questions and send form by mail or e -mail. 1) Please give approximate dates during which you were closely associated with the applicant. / / to / / 2) Does the applicant have any objectionable habits? 3) Please estimate the applicant s ability in his/her profession, occupation, or school. 4) Please rate the applicant s capability and suitability for work with Circle 6 Ranch Baptist Camp. 5) To your knowledge, has the applicant committed, been accused of, or charged with, mistreatment, abuse or molestation of children in the past? Yes or No 6) To your knowledge, has the applicant been the victim of mistreatment, abuse, neglect, or molestation? Yes or No 7) To your knowledge, does the applicant have a criminal record other than minor traffic violations? 8) Specify instances concerning applicant s working with or supervising children, whether positive or negative: 9) If you were making the decision, would you employ this person to work with children, youth, and adults? 10) Please leave the field blank if you have had no opportunity to observe or if you feel uncertain of an appropriate answer. RATING LOW - AVG. AVG. + AVG. HIGH Leadership Team Work Cooperation Intelligence Personal Appearance Ability to Perform Physical Labor Social Acceptance Sense of Humor Emotional Stability Applicant s Printed Name Reference s Printed Name Reference s Signature Reference s Title/Position/Relationship to Applicant:

5 STAFF REFERRAL Circle 6 is a Christian camp for children, youth and adults. Please answer the questions and send form by mail or . 1) Please give approximate dates during which you were closely associated with the applicant. / / to / / 2) Does the applicant have any objectionable habits? 3) Please estimate the applicant s ability in his/her profession, occupation, or school. 4) Please rate the applicant s capability and suitability for work with Circle 6 Ranch Baptist Camp. 5) To your knowledge, has the applicant committed, been accused of, or charged with, mistreatment, abuse or molestation of children in the past? Yes or No 6) To your knowledge, has the applicant been the victim of mistreatment, abuse, neglect, or molestation? Yes or No 7) To your knowledge, does the applicant have a criminal record other than minor traffic violations? 8) Specify instances concerning applicant s working with or supervising children, whether positive or negative: 9) If you were making the decision, would you employ this person to work with children, youth, and adults? 10) Please leave the field blank if you have had no opportunity to observe or if you feel uncertain of an appropriate answer. RATING LOW - AVG. AVG. + AVG. HIGH Leadership Team Work Cooperation Intelligence Personal Appearance Ability to Perform Physical Labor Social Acceptance Sense of Humor Emotional Stability Applicant s Printed Name Reference s Printed Name Reference s Signature Reference s Title/Position/Relationship to Applicant:

6 STAFF REFERRAL Circle 6 Ranch is a Christian camp for children, youth and adults. Please answer the questions and send form by mail or . 1) Please give approximate dates during which you were closely associated with the applicant. / / to / / 2) Does the applicant have any objectionable habits? 3) Please estimate the applicant s ability in his/her profession, occupation, or school. 4) Please rate the applicant s capability and suitability for work with Circle 6 Ranch Baptist Camp. 5) To your knowledge, has the applicant committed, been accused of, or charged with, mistreatment, abuse or molestation of children in the past? Yes or No 6) To your knowledge, has the applicant been the victim of mistreatment, abuse, neglect, or molestation? Yes or No 7) To your knowledge, does the applicant have a criminal record other than minor traffic violations? 8) Specify instances concerning applicant s working with or supervising children, whether positive or negative: 9) If you were making the decision, would you employ this person to work with children, youth, and adults? 10) Please leave the field blank if you have had no opportunity to observe or if you feel uncertain of an appropriate answer. RATING LOW - AVG. AVG. + AVG. HIGH Leadership Team Work Cooperation Intelligence Personal Appearance Ability to Perform Physical Labor Social Acceptance Sense of Humor Emotional Stability Applicant s Printed Name Reference s Printed Name Reference s Signature Reference s Title/Position/Relationship to Applicant: