2018 SWOK Kids' Camp Counselor/Camp Worker Application
REGISTRATION FOR JULY 9-12, 2018
Email address *
First Name *
Your answer
Last Name *
Your answer
Gender *
Street Address *
Your answer
City *
Your answer
State *
Your answer
Cell Phone: *
Your answer
Workplace: *
Your answer
Work Phone: *
Your answer
Emergency Contact Name/Relationship: *
Your answer
Emergency Contact Number: *
Your answer
Church Name *
Allergies (Food/Environmental) --If none, write N/A: *
Your answer
Drug Allergies--If none, write NKDA (No Known Drug Allergies) *
Your answer
List churches (with pastor's name) that you have regularly attended for the past 5 years: *
Your answer
List church work involving children or youth (Name of each church, type of volunteer work, and dates): *
Your answer
List any other non-church work involving children/youth (Name of organization, type of volunteer work, and dates): *
Your answer
Name of church where you are a member: *
Your answer
How many months/years you have attended: *
Your answer
1. Personal reference (not former employers or relatives) with name and phone number: *
Your answer
2. Personal reference (not former employers or relatives) with name and phone number: *
Your answer
3. Personal reference (not former employers or relatives) with name and phone number: *
Your answer
T-Shirt Size *
I have read the 2018 Kids Camp Counselor Training Manual *
Required
I agree to turn in the completed SWOK District Background Check Form and copy of my Driver's License or ID to my local Church by June 1. *
Required
A copy of your responses will be emailed to the address you provided.
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