Returning Staff Application 2017
For any questions regarding this application:
Phone: 276-328-6876 (office) 1-800-359-4049 (toll free)
Email: info@campbethel.com
PERSONAL INFORMATION
Name
(First Middle Last)
Your answer
Date
Your answer
Date of Birth
Your answer
Age
Your answer
Gender
Permanent Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Preferred Mailing Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Cell Phone
Your answer
Email
Your answer
EDUCATIONAL INFORMATION
School Currently Attending
Your answer
Year/Grade Completed As of June 2017
Your answer
GPA
Your answer
Major
Your answer
Anticipated Graduation Date
Your answer
MEDICAL INFORMATION
*Your insurance will be considered primary and Camp Bethel's will be secondary (only in applicable situations).
Insurance Company
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Name of Policy Holder
Your answer
Policy #
Your answer
Group #
Your answer
Phone
Your answer
In case of emergency, please notify:
Your answer
Relationship
Your answer
Phone
Your answer
Or Notify:
Your answer
Relationship
Your answer
Phone
Your answer
Please list any current medications:
Your answer
Please list any allergies:
Your answer
Please list any changes in your medical history since last summer:
Your answer
Do you have any medical/physical restrictions that would limit your performance in the job for which you have applied?
Your answer
If yes, please specify:
Your answer
Have you ever received medical treatment for nervous breakdown or other mental health disorders?
If yes, please specify:
Your answer
SUMMER POSTION
Previous Position Held:
Your answer
Years:
Your answer
Previous Position Held:
Your answer
Years:
Your answer
Previous Position Held:
Your answer
Years:
Your answer
Please check what position(s) you are interested in serving:
Required
Please check all CURRENT certifications held: (must be up to date)
SPIRITUAL LIFE
Home Church
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Pastor
Your answer
Phone
Your answer
Current Church (if different from home church)
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Please describe your current views in the following areas:
Dating
Your answer
Homosexuality
Your answer
Pre-marital Sex
Your answer
Alcohol
Your answer
Drug/Tobacco Use
Your answer
Have you ever been involved in or accused of sexual, physical or emotional abuse of a child?
Have you ever been involved in criminal or illegal activity?
Have you ever been arrested?
Have you ever been convicted of a felony?
If you answered yes to any of the above questions, please explain the situation in detail, including the steps you have taken to deal with the situation:
Your answer
Please describe your current walk with Christ:
Your answer
Please evaluate your experience as a Camp Bethel staff member. Tell us what you enjoyed most, what you learned, how your walk with Christ was strengthened and why you want to return as a staff member this summer:
Your answer
STATEMENT OF FAITH
Camp Bethel believes:

- In the entire Bible as the inspired Word of God

- In the one triune God - Father, Son, and Holy Spirit

- That man is totally depraved and in need of salvation

- That salvation is by grace through faith, and is made possible because of the virgin birth, death, burial, and bodily resurrection, and ascension of Christ Jesus.

- That the Holy Spirit indwells in each believer, and that the believer's life is to be yielded to Him

- That the believer is kept by the power of God and thus is secure in Christ now and for eternity

- In eternal life with God for the saved and eternal punishment in hell for all who reject Jesus Christ.

- In the personal, imminent return of our Lord and Savior Jesus Christ .

I have read and agree with the Camp Bethel Ministries Statement of Faith
Signature / Date
Your answer
I have read and DO NOT agree with the Camp Bethel Ministries Statement of Faith
Signature / Date
Your answer
Please state the reason for your disagreement here
Your answer
SUMMER COMMITMENT
All summer staff members are required to attend orientation unless other arrangements have been made with the camp director. Orientation is especially important for potential cabin leaders. Please check all dates you will be able to serve this summer. (If you work less than 5 weeks, you will be considered a volunteer).
*Additional weeks to serve available
Required
Weekends off begin Saturday after all work is complete and end on Sunday at 5:00PM. Any change in time of departure or return must be approved by the camp director. You are allowed two weekends off. Please list below the weekends you will be requesting off (subject to approval).
Your answer
Please Read and Initial Under Each Statement
Our desire is to have staff members who are flexible and who will be willing to serve where and when needed. I am willing to serve wherever I am assigned and I am willing to perform all assigned tasks , regardless of how insignificant they seem, to the best of my ability.
Your answer
I am willing to actively and enthusiastically support all of the programmed activities, Including but not limited to team games and competition, skits, morning exercises, etc.
Your answer
If accepted for a position, I will follow all rules and regulations of the camp, as listed in the staff manual. I understand that failure to abide by the rules may result in my immediate dismissal.
Your answer
I am willing to submit to those in authority over me, including my peers that may be placed in authority over me.
Your answer
I agree to submit to a drug test if needed.
Your answer
I commit to work the entire summer, with the exception of approved time away at the discretion of the Camp Director.
Your answer
For Parents/Guardians of Applicants Under 18
Please read the following before signing below:
The health information and history updates are correct and the applicant has my permission to engage in all prescribed camp/staff activities. If I cannot be reached in an emergency, I hereby give permission to Camp Bethel Ministries to secure proper medical treatment. I have read the application, I agree to the background check if needed.
Signature of Parent/Guardian / Date
Your answer
All Other Applicants
By signing my name below, I am affirming that the information contained in this application is accurate to the best of my knowledge. I also understand that (1) any false information given will result in its cancellation and, if I am employed, may be cause for immediate dismissal; (2) employment is subject to satisfactory reference and employment checks and verification of employment. I hereby give Camp Bethel Ministries staff permission to verify all information in this application by contacting any person or organization to obtain information concerning me. I release and agree not to hold harmless from liability any person or organization (whether listed in application or not) who provides information or reference about me to Camp Bethel Ministries or its employees or agents. I also hereby release and agree to hold harmless Camp Bethel Ministries and its Directors, officers, and employees with respect to the obtaining of such information about me. I waive any and all rights I might have to inspect the reference provided on my behalf. If hired, I understand that I will be working under supervision of the Camp Bethel Staff and I am subject to the rules and regulations of the camp. I promise to obey all of the Camp Bethel rules, day and night, and I understand that I will be sent home if I fail to do so.
Applicant Signature / Date
Your answer
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