Summer Mission Project Returning Member Application--Step 1 of 2

Please complete the following form for Step 1 of the Summer Mission Project Application Process.  All fields marked with an (*) are required.  Once the form is completed, press the "Submit" button at the bottom of the page.  If this form is not completed in full and not submitted, no information will be saved.  Thank you.
 

Encampment Name	*
Encampment Date	*
GENERAL INFORMATION
Applicant's First Name	*
Applicant's Last Name	*
Gender	*	Female Male
Birthdate	*	- - Choose One - - January February March April May June July August September October November December *- - Choose One - - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 * - - Choose One - - 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984
Age	*
Address	*
City	*
State	*	- - Choose One - - AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Zip	*
Home Phone Number	*
Cell Phone Number	*
Email	*
Confirm Email	*
Preferred Position	*	--Choose One-- Counselor Nurse Store Food Service Lifeguard A/V Rec. Staff Other
T-Shirt Size	*	--Choose One-- Small Medium Large XL XXL XXXL
Personal Testimony
Describe your relationship with God at this present time.	*
How has God been developing you in a specific area of your life since last summer?	*
What has God been teaching you in your church service and mid-week Bible studies?	*
What ministry within your church or other Christian organization are you currently serving with? Please describe your roles and responsibilities.	*
Why do you think God is leading you back to Indian Hills Camp for another summer of ministry?	*
What has been the hardest part about sticking to the goals you made at the end of last summer?	*
How do you think God feels about you?	*
Additional Comments
A SAFE COMMUNITY
Dear Applicant,
We know that the Summer Mission Project can be a very rewarding experience, and we appreciate your interest in applying. Due to the nature of IHC's Summer Camp ministry with elementary age children, it is our highest priority to ensure the safety of our campers. Every summer IHC serves a wide variety of children. For this reason, it is our policy to screen all applicant's desiring to serve at IHC. Furthermore, because the Summer Mission Project is designed for extensive interaction between Summer Mission Project participants and our campers, we request your help in the screening process by completing the following questions. Please note that a "yes" answer to any of these questions will not automatically exclude you from participation, as all applicants are reviewed on a case by case basis.
Have you at any time ever:
Been arrested for any reason?	*	Yes No
Engaged in or been accused of any act of violence, neglect, abuse, or molestation of any child or adult?	*	Yes No
Engaged or been accused of any act of drug or alcohol abuse?	*	Yes No
As far as you are aware:
Is there any circumstance or pattern in your life that would make it inapproriate for you to serve with minors or would compromise the integrity of Indian Hills Camp?	*	Yes No
If the answer to any of these questions is "Yes", pleaase explain in detail.
Read these commitments carefully and initial in the box next to each statement. By typing your initials, you the applicant, are committing to these statements.
In the event of acceptance, I would consider it a privilege to undertake any responsibility given to me by the IHC Administration.	*
In the event of acceptance, I am able to attend the IHC Training Session from June 15-June 22, 2012.	*
If I am accepted, I am available and will commit myself to fulfill my contract dates, starting June 15th, 2012, and ending August 17, 2012.	*
I authorize all previous employers to furnish records, including the reasons for leaving, and all information that they may have concerning me. I hereby release Shiloah Springs Bible Retreat, Inc. (aba Indian Hills Camp) from all liability or damage arising there from.	*
If I am accepted, I will commit to filling out and turning in any required paper work needed on time and when requested.	*
I am interested in participating at Indian Hills Camp this summer. I understand I have to raise $1,500.	*
By typing my name below, I, the Applicant named above, certify that all statements given on this application are accurate and realize that falsification or misrepresentation of this or any other personal record may result in my dismissal from the Summer Missions Project.
Applicant's First Name	*
Applicant's Last Name	*
Applicant's Electronic Signature (please enter full name)	*
Today's Date	*
Security Code	*
Thank you for completing Step 1 of the 2012 Summer Mission Project Application Process. An application successfully submitted will redirect you to a thank you page on the Indian Hills Camp website. If you are not redirected to a thank you page, your form has not been successfully submitted. Please ensure that all fields are completely and correctly filled out if not redirected. After submitting this form you will receive an e-mail at the address you provided above. Open the e-mail and follow the directions in order to complete the Application Process.