2013 Summer Jr. Staff Application

All Fields marked with a * are required.

If you are unable to answer a required field please type n/a in the blank.


First Name	*
Middle Name
Last Name	*
Gender	*	Male Female
Date of Birth	*
Current Address (include city, state, zip)	*
Permanent Address (if different from above)
Cell Phone
Phone	*
Email	*
Present School Name	*
Grade	*
Present Occupation / Employer	*
Social Security #

Do you have a valid Driver's License?	*	Yes No
License ID #
State
Expiration Date

Home Church	*
Pastor's Name	*
Church Address	*
Church Phone	*

How did you learn about staff opportunities at Camp JIM?

.......................................................................................................Disciples in Training Program Description........................................................................................................

DISCIPLES IN TRAINING is an intensive 4 day Christian Leadership camp designed for Christian young people to develop as disciples of Christ. Upon successful completion of the training, participants will be equipped to serve at the Camp as Jr. Staff, either as Program or Kitchen Staff, and/or in their local communities as they grow to be Christian adults.

Who should apply?
Only youth (ages 14-17) who have made a commitment to following Jesus and are serious about developing their leadership skills, opening themselves to accountability, and have a desire to gain more knowledge about God and the Bible.

What is included in the training?
The schedule is packed with training sessions on how to share your faith, dig deeper into God’s Word and how to share your testimony. You will be planning large group activities for the camp-ers and creating devotions to share with the campers. There will be campfires, worship times, bond-building activities, and a canoe trip to test your endurance and much more. Oh yeah, there will be lots of great food too. This will be a great time to grow in your relationship with God and meet a lot of friends that will encourage you to love God more.

When does it start?
This Leadership camp will go from June 12-15. In order to serve in this capacity during the summer you must be able to attend the training.

...........................................................................................................Spiritual Background...........................................................................................................
What are your convictions concerning the following issues?
The authority of God’s Word?	*
Use of alcohol, drugs and/or tobacco?	*
Premarital Sex?	*
Homosexuality?	*
Music / Movies?	*
Do you struggle with any of the items listed above and what actions are taken to help you combat them?	*
Tell about how you became a Christian?	*
How does a person become a Christian?	*
What actions or activities do you do to maintain and grow in your relationship with Jesus?	*
Why do you want to be a part of the Disciples in Training program?	*

..................................................................................................................References..................................................................................................................

APPLICANTS PLEASE NOTE:
Three references MUST be submitted in addition to this application. Please do not use close family members, such as parents or grandparents as references. We cannot process your application until all three of your references are in. YOU CAN HAVE YOUR REFERENCES FILL OUT A FORM AT http://campjim.org/?201200006 OR SEND THEM A FORM WITH A POSTAGE PAID ENVELOPE ADDRESSED TO CAMP JIM, 1026 Camp JIM Road SW, Pillager, MN 56473. Reference forms are available online at http://campjim.org/?201200006 or upon request.

Pastoral Reference (From your Senior Pastor, Youth Pastor, or youth sponsor (someone who is familiar with your spiritual walk):
Name	*
Phone	*
Chruch	*
Email	*
Address	*

Work Reference (From someone who can comment on your work habits (Babysitting, lawn mowing, etc. counts):
Name	*
Phone	*
Email	*
Address	*

Character Reference (From an adult who knows you well and can comment on your character/personal qualities):
Name	*
Phone	*
Email	*
Address	*


......................................................................................................Personal History and Health....................................................................................................

Have you ever...
Been involved with drugs and alcohol?	*	Yes No
Been convicted of physical or sexual abuse?	*	Yes No
Been convicted of any crime, felony or misdemeanor?	*	Yes No
Do you have any physical limitations that require special attention?	*	Yes No

Explain any “yes” answers to the questions above:


A summer staff position is emotionally and physically demanding. Staff are required to participate in activities with campers and need to be able to keep a close watch over the campers in their charge. Are you aware of any reasons you would not be able to fulfill the essential functions of a position you are requesting?	*	Yes No
If so, please explain:

How would you combat emotional, physical and/or spiritual exhaustion if on Camp JIM’s staff?	*


.........................................................................................................................Skills........................................................................................................................

Ball Field Games
Camping/Nature Skills
Group Activities
Nature Activities
Archery
Music Skills (please list)
Carpentry
Cleaning / Upkeep
Dishwashing
Small Engine Repair
Canoeing
Fishing
Swimming
Air Rifles
Drama
Audio / Visual
Photography / Video
Kitchen Help
Climbing
Challenge Course

Licenses / Certifications

EMT	*	Yes No
Expiration Date

First Aid	*	Yes No
Expiration Date

Advanced First Aid	*	Yes No
Expiration Date

CPR	*	Yes No
Expiration Date

WSI	*	Yes No
Expiration Date

Lifeguard	*	Yes No
Expiration Date


...........................................................................................................Summer Commitment..........................................................................................................
Summer Schedule
Please Check the lines next to the week that you would be able to attend
June 12th - 15th Jr. Staff Training (required attendance)
June 17th - 19th Cub Camp Grades 1-3	*	Yes No
June 23rd - 29th Sr. High Camp Grades 9-12	*	Yes No
June 29th - July 2nd Family Camp All ages	*	Yes No
July 7th - 12th Junior Camp Grades 3-5	*	Yes No
July 14th - 19th Intermediate Camp Grades 5-7	*	Yes No
July 21st - 27th Junior High Camp Grades 7-9	*	Yes No
Do you anticipate any conflicts during your term of employment?	*	Yes No
If yes, please list dates and reason:

PLEASE NOTE: The Jr. Staff program is a volunteer position, if you are 17 years old and work at least 3 weeks you will qualify for $50 per week.


..............................................................................................................Statement of Faith.............................................................................................................

1. We believe the Bible to be the inspired, the infallible, authoritative word of God.
2. We believe that there is one God, eternally existent in three Persons: Father, Son and Holy Spirit.
3. We believe in the deity of our Lord Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in his vicarious and atoning death through His shed blood, in His bodily resurrection, in his/ ascension to the right hand of the Father, and in His personal return in power and glory.
4. We believe that for the salvation of lost and sinful men, regeneration by the Holy Spirit is absolutely essential.
5. We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life.
6. We believe in the resurrection of both the saved and the lost; they that are saved unto the resurrection of life and they that are lost unto the resurrection of damnation.
7. We believe in the spiritual unity of believers in Christ.


....................................................................................................................Agreement....................................................................................................................

I agree with the above Statement of Faith, and I understand that because Camp JIM is an non-denominational camp and does not wish to offend other believers, I will agree to refrain from teaching or discussing doctrinal issues (such as baptism, communion, end times, speaking in tongues, etc.) about which evangelicaldenominations may hold differing views.
I hereby certify that the information I have given in this application is accurate and factual to the best of my knowledge.
I hereby give permission to Camp JIM to publish photographic, video images, and recordings of the applicant for promotional purposes.
If accepted for a summer staff position at Camp JIM, I will abide by the expectations, policies, and principles, both verbal and written asked of me and will accept my proper responsibilities as a member of the camp community. It will by my chief aim to make the Lord Jesus Christ real in the lives of campers as they see Christ in me. I understand that disregarding of any of the above may result in my dismissal from camp staff. I further understand that Camp JIM’s Director or myself may terminate this employment agreement at any time for any reason.
I hereby authorize Camp JIM to contact all prior employers, any references listed herein and law enforcement (background checks by a second party) to verify all information provided and to obtain any and all information related to my character and past work performance. I further hereby release all prior employers and references from any liability for information provided in good faith.

Signature	*
Date	*

If the applicant is under 18 years of age, either a parent or guardian must sign below. Your signature indicates that this application is made with full approval on your part and signifies your permission for the applicant to complete the necessary application, child protection forms and interviews. This also authorizes camp to transport you child off camp to camp approved camp functions.

Signature
Date

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