Zoho Creator - Counselor/CCA Application

Counselor/CCA Application

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Biographical Information

First Name *

Last Name *

Street Address/P.O.Box

City

State

Zip

Phone

Email *

Gender
Male
Femail

Age

Grade in fall?

Birth date [dd-MMM-yyyy]

Parent/Guardian

First Name

Last Name

Relationship to you?

If you address is changing after June. Please give
us your summer address.

Street Address/P.O. Box

City

State

Zip

Phone

Have you ever been convicted of a felony involving a minor?
Yes
No

Are you in good health?
Yes
NO

PLEASE NOTE: SMOKING is not permitted while at Calvin Crest.

Physical Handicaps/Chronic Ailments?

Have you been to Calvin Crest before?
Yes
No

Most recent year?

Indicate number of year(s) as a Camper

Indicate number of year(s) as AIMer

Have you been a counselor before?
Yes
No

When and where have you counseled?

Have you been a CCA before?
Yes
No

When and where have to been a CCA?

Do you know anyone currently on staff?
Yes
No

If "yes", whom?

What other camp or conference experience have you had?

CHURCH AFFILIATON

Name of church you attend

What programs do you attend?

How often do you attend?

Pastor's First Name

Pastor's Last Name

Church Street Address

City

State

Zip

Have you held any form of leadership?
Yes
No

If "yes" please describe

REFERENCES

Two completed Personal Reference Forms are required.
One from your Pastor or Youth Director and one from a
Christian Teacher, Church Elder, or employer that is not
related to you.

1. First Name

Last Name

Relationship

Ref 1 Email *

2. First Name

Last Name

Relationship

Ref 2 Email *

In Your Own Words:

Are you a Christian?
Yes
No

Explain the Gospel of Jesus Christ

Why do you want to be counselor/CCA?

What are characteristics of a good counselor/CCA?

What experience do you have working with the age you'll be working with?

How many weeks would you like to counsel?

If you only want to do one week, please give us
your choices below.

First Choice

Second Choice

Third Choice

If you can do multiple weeks, please select Week 1 6/15-21 Family Camp
Week 2 6/22-28 Miwok
Week 2 6/22-28 Junior High
Week 2 6/22-28 Sherwood
Week 3 6/29-7/5 Family Camp
Week 4 7/6-12 WeekInForest
Week 4 7/6-12 Outpost
Week 4 7/6-12 High School
Week 5 7/13-15 Miwok A
Week 5 7/15-19 Miwok B
Week 5 7/13-19 Sherwood
Week 5 7/13-19 Junior High
Week 6 7/20-26 Sherwood
Week 6 7/20-26 Outpost
Week 6 7/20-26 High School
Week 7 7/27-8/2 Miwok
Week 7 7/27-8/2 Sherwood
Week 7 7/27-8/2 Junior High
Week 8 8/3-9 WeekInTheForest
Week 8 8/3-9 Outpost
Week 8 8/3-9 High School
Week 9 8/10-16 Sherwood
Week 9 8/10-16 Junior High

PLEASE READ CAREFULLY

I UNDERSTAND that as a volunteer at Calvin Crest,
I will be under the direct supervision of the staff
person(s) assigned.

I WILL ACCOMPLISH my particular daily assignment and
and participate in the programmed group Bible studies and
activities, practicing a positive attitude toward my work and
persons with whom I serve.

I HAVE READ AND WILL ABIDE by the guidlines and expectations
set forth in the Volunteer Counselor Manual/CCA Guidelines, and will
cooperate with whom I serve.

I WLL ASSUME responsibility for my personal appearance and
actions and realize that if my work or behavior is unsatisfactory,
I may be separated from the program.

I WILL BE OF SERVICE in any way I can, and in whatever
I do, I will work toward the achievement of the purpose of
Calvin Crest:

"To serve as a witness to the love of Jesus Christ
and to guide persons to Him, so that they may
live and grow as His disiciples through the fellowship
of the Church."

I agree to the statements above *

Date [dd-MMM-yyyy]

Verification Code

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