Application – College Age





Name (required)

Email (required)

Phone

Age (required)

Date of Birth (required)

Home Address

City

State

Zip

Home Church

Pastor

College attending (if any)

College Address

Your College Box Number

Desired Position

Would you be available to be at camp from May 29 through July 31, 2018?
YesNo

If you answered “No” what dates would you not be available?

Have you worked at camp before?
YesNo

Where and when have you worked at camp?

Have you ever been accused of, participated in, or been convicted of any sexual abuse?
YesNo

Please provide any other information that may be helpful.

By typing you name, you are signing that the above information is true and accurate.

Perhaps you recognize some of the delightful young people that have work at Servant’s Heart in 2017.

                2017 Summer Staff

If you do not receive a preliminary response within 10 days, please contact us.