Volunteer Application
Summer Camp Staff Volunteer Application Name: _______________________________________ Camp Yavapines Summer 2015 Our goals are to: Connect each camper with Jesus. Ignite their active love for Him. Forge them into spiritual leaders who will share the Good News of Jesus. Staff Qualifications: Have a daily growing relationship with Jesus Christ. Be able to communicate Christ as a personal Savior and loving friend to both campers and staff. Have a positive attitude with an ability to fulfill responsibilities. Work as a team player. Be kid-focused and have a desire to see them accept Jesus as their Savior. Be in good health and vitality. Be able to take directions and implement advice. Be FLEXIBLE! Arizona Conference of Seventh-day Adventists Camp Yavapines 2999 W. Iron Springs Road - Prescott, AZ 86305 Phone: 928-445-2162 Fax #928-445-8043 Email: [email protected] FOR OFFICE USE ONLY Applicant Name ___________________________ Date Application Received _____/_____/________ Type Position _____________________________ Date Interviewed __________________________ PERSONAL Name _________________________________________________ Age ________ Soc. Sec. # ___________________ Home Address ____________________________________________________________________________________ School Dorm Address _______________________________________________________________________________ Phone ___________________________________________ Mobile _________________________________________ T-shirt size (circle) S M L X XXL Marital Status: Single ___ Married ____ Divorced ____ Current occupation or work __________________________________________________________________________ Supervisors _______________________________________________________________________________________ School offices and responsibilities held _________________________________________________________________ School you will attend next year ________________________________________ Grade next year ________________ Are you SDA? Yes ____ No ___ Home Church ______________________________ Pastor _______________________ What commitments do you have for next summer? (engagement, marriage, wedding, vacations, family plans, etc.) _________________________________________________________________________________________________ CAMP EXPERIENCE For which staff position are you applying? (Please list in priority) 1. ______________________________________ 2. ______________________________________ 3. ______________________________________ What are your qualifications for these positions? 1. _____________________________________________________________________________________________ 2. _____________________________________________________________________________________________ 3. _____________________________________________________________________________________________ Have you ever been a camper? _________ If yes, where? _________________________________________________ Please list any paid camp staff experience: Where: ___________________________ Position: ____________ Year: _________ Camp Director: ______________ Where: ___________________________ Position: ____________ Year: _________ Camp Director: ______________ Where: ___________________________ Position: ____________ Year: _________ Camp Director: ______________ HEALTH Your present health: Excellent ___ Good___ Fair ___ Poor___ Last injury or surgery: _______________________________________________________________________________ List any allergies: ___________________________________________________________________________ Do you have any physical handicaps? _________________________________________________________________ Who should be contacted in case of emergency? ________________________________________________________ Name: _____________________ Relationship:________________ Phone: ______-______-_______________ SKILLS AND INTERESTS Arts and Crafts Circle (1 for interest, 2 for knowledge, 3 for skill) Waterfront Miscellaneous Ceramics 1 2 3 Canoeing 1 2 3 Braiding 1 2 3 Swimming 1 2 3 Indian Lore 1 2 3 Springboard Diving 1 2 3 Leather Craft 1 2 3 W.S.I. 1 2 3 Pottery 1 2 3 Sculpturing 1 2 3 Soap Craft 1 2 3 Weaving 1 2 3 Safety Basic Rescue 1 2 3 CPR 1 2 3 First Aid 1 2 3 Certified Life Guard 1 2 3 Music Camp Songs 1 2 3 Song Leading 1 2 3 Special Music 1 2 3 Instruments __________ 1 2 3 Other skills and interests we should know about: __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ Programming Devotional Talks 1 2 3 Group Games 1 2 3 Skits/Plays 1 2 3 Puppets 1 2 3 Archery 1 2 3 Mountain Biking 1 2 3 Horsemanship 1 2 3 Go Kart/Auto Mechanics 1 2 3 Gymnastics 1 2 3 Camping Skills Rock Climbing/ Rappelling 1 2 3 Camp Cookery 1 2 3 Fire Building 1 2 3 Zip Line 1 2 3 Hiking 1 2 3 Mountain Boarding 1 2 3 Knots 1 2 3 Orienteering 1 2 3 Disc Golf 1 2 3 Tent Camping 1 2 3 Other _____________ 1 2 3 Other _____________ 1 2 3 SPIRITUAL SELF-EVALUATION Excellent Above Average Average Below Average Regularly Occasionally Rarely Not a Practice I perceive my spiritual condition as My teachers perceives my spiritual condition as My best friends perceive my spiritual condition as: My spiritual involvement is: Please give examples: ______________________________ _________________________________________________ CHRISTIAN BEHAVIOR I have prayer and devotions I am involved in outreach activities * I attend Sabbath School and Church My use of tobacco or alcohol is: * Please specify or add your comments: ________________________________________________________________ UNLAWFUL CONDUCT Have you been (formally or informally) accused, charged or disciplined for any unlawful sexual conduct, child abuse, and/or child sexual abuse? Yes ___ No___ Have you been (formally or informally) accused, charged or disciplined for use of any illegal drugs? Yes___ No___ Signed ______________________________________ Date _____________________ PATHFINDER INVOLVEMENT Were you a Pathfinder? Yes___ No___ What is the highest Pathfinder class completed? __________________ List as many Pathfinder Honors earned as you can remember (use backside if necessary) _________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Any outstanding Pathfinder experiences? _______________________________________________________________ _________________________________________________________________________________________________ Complete each statement: “I want to work for Camp Yavapines because… ___________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ “I believe the aim and purpose of a summer camp should be … _____________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ How and why did you become a Christian? ______________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ What makes your lifestyle as a Christian unique? _________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ How do you personally maintain a daily relationship with Jesus? ____________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ RECOMMENDATIONS Please list the individuals who will be sending in your recommendation forms (not a relative): 1. Name: ________________________________________________ Phone: ________________________ Address: _______________________________________________ Position: _______________________ 2. Name: _________________________________________________Phone: ________________________ Address: _______________________________________________ Position: _______________________ 3. Name: _________________________________________________Phone: ________________________ Address: _______________________________________________ Position: _______________________ Optional Information: Date of Birth _____________________________ Thank you for your candid responses. This information is confidential, and is intended to be reviewed only by the hiring personnel. Yavapines Staff Emergency Form Name:____________________________________ Age:_______ Gender:__________ Birth Date:________________ City:_______________ State:_______ Zip:_________ Home Phone: ___________________ Mobile Phone: __________________ Emergency Contact Information 1. Name:______________________________ Relationship: ________________________ Home Phone: ________________________ Mobile Phone: _______________________ 2. Name: _____________________________ Relationship: ________________________ Home Phone: ________________________ Mobile Phone: _______________________ Insurance Information Primary Insurance Carrier: _______________________ Policy Holder’s Name: __________________________ Policy Number: ________________________________ Group Number: ________________________________ Allergies (medication, food, animals, etc.) and reaction: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Current Prescription Medications: ___________________________________________________________________________ ___________________________________________________________________________ Medical Conditions (Anemia, High Blood Pressure, Hearing Loss, Asthma, Diabetes, etc.) ___________________________________________________________________________ ___________________________________________________________________________ Signature___________________________________________Date__________________
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