HCC ~ Summer Staff Application
Email address *
Name *
First and last name
Phone number xxx-xxx-xxxx *
Please provide information for your last two employers.
1) Employer Name
Phone Number xxx-xxx-xxxx
Start Date
MM
/
DD
/
YYYY
End Date
MM
/
DD
/
YYYY
2) Employer Name
Phone Number xxx-xxx-xxxx
Start Date
MM
/
DD
/
YYYY
End Date
MM
/
DD
/
YYYY
List two references who can verify you are pursuing spiritual growth as a college student.
Name
Relationship
Phone Number xxx-xxx-xxx
Name
Relationship
Phone Number xxx-xxx-xxxx
Church you are attending while at college.
Church Name
Contact Name
Phone Number xxx-xxx-xxxx
Describe your involvement in this church.
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This form was created inside of Harrisburg Christian Church. - Terms of Service