Returning Staff Application

Submitted by admin on Wed, 10/12/2011 - 20:31

Name: *

Age: *

Birth Day: *

Gender: *

Male

Female

Permanent/Home Address: *

Home Phone Number:

Temporary/College Address:

Cell Phone:

Email: *

Dorm/Apt Phone:

Drivers License #: *

Drivers License State:

I am a:: *

College student

High school student

Recent College Graduate

School Name:

Major:

I am employed:

Full-Time

Part-Time

Employers name:

I am willing to serve:: *

See list of available positions

Any position

Only the positions listed

1st Choice Position: *

2nd Choice Position: *

3rd Choice Position: *

Have you been accused of misconduct with a minor or a felony?: *

Yes (If yes, please explain in a follow up email to grow@sciotohills.com)

Criminal Record: *

Have you been (or are currently in the process of being) formally charged, arrested for or convicted of crimes in relation to drug or alcohol abuse, domestic violence, or any type of criminal sexual conduct (including but not limited to, pornography, child abuse/molestation, homosexuality or incest)?

Yes (If yes, please explain in a follow up email to grow@sciotohills.com)

Have you ever been involved with narcotics? : *

Yes

If hired, I agree to refrain from smoking, drinking alcoholic beverages, and involvement with narcotics: *

Yes

What year(s) did you serve and position(s) did you fill on summer staff at Scioto Hills?: *

Do you have new skills we should know about (licenses, certifications, outdoor courses, etc)? : *

Describe what you learned while serving as a summer staff member at Scioto Hills Christian Camp.: *

How have you grown in your personal relationship with Christ since last summer?: *

What do you hope to learn and/or develop if you serve on staff again this summer?: *

I have not been accused of harassment of any person, including, but not limited to, workplace harassment. : *

(The camp’s policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment. A prior accusation is not an automatic bar to employment. The type of accusation and when it occurred will be evaluated by the camp before any decision is made.)

Yes

I authorize investigation of all statements herein and release Scioto Hills and all others from liability in connection with the same: *

I further authorize the State Police to conduct a criminal history check to determine the existence of any arrest resulting in conviction and to furnish a response to Scioto Hills. I understand that, if employed, I will be an at-will employee. I also understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery.

Yes

If employed, I agree to abide by the spiritual standards of Scioto Hills Christian Camp as well as all applicable policies & procedures. I understand this includes my agreement to refrain from smoking, drinking alcoholic beverages, and involvement with n: *

Yes

In the event of employment, I will commit myself to fulfill my contract dates.: *

Yes

In the event of employment, I would consider it a privilege to perform any responsibilities assigned to me by Scioto Hills’ staff.: *

Yes

Signature: *

Type your name here to sign this form.

Date: *

I can arrive on May 29, 2012: *

Yes

I can serve through July 21, 2012: *

Yes

Please contact me:

Please call me to arrange an interview at camp.

Please call to arrange interview at Cedarville University

Please contact me for other interview options.

Reference Name: *

Reference Phone: *

Reference Email: *

Relation to Reference: *

Sciotohills