Summer Mission Staff 2017 Application--Step 1 of 2

Please complete the following form as Step 1 of the Summer Mission Staff 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	* Select the dates that correspond to the type of position you are applying for. If you are not sure, select the 'General Mission Staff' option.	--Chose One-- June 18 - July 9, 2017 (General Mission Staff) June 17 - July 9, 2017 (Lead Mission Staff) June 12 - July 9, 2017 (Deans and Team Counselors)
GENERAL INFORMATION
Applicant's First Name	*
Applicant's Last Name	*
Gender	*	Female Male
Birth Date	*	- - 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 *
	*
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	*
College/ University Name
Area of Study
Graduation Year
Church Name	*
Pastor	*
PARENT/GUARDIAN INFORMATION
If you are under 18, please list contact information for a parent or guardian.
Name of parent or guardian	*
Email Address	*
Phone Number	*
WORK EXPERIENCE
Are you currently employed?	*	Yes No
If yes, please submit the following information:
Company Name
Supervisor's Name
Supervisor's Phone Number
May we contact your employer?	*	Yes No N/A (I'm not employed)
SPECIAL SKILLS
Do you speak any languages other than English? If so, please list along with skill level.	*
Musical Talents		Musical Instrument Vocals Worship Arts Other
Musical Experience
Special Certification/Skills		Paintball Zipline Crafts Field Games Water Games Archery Face Painting Balloon Animals Juggling Other
Special Certification/Skills Experience
Teaching Experience		Yes No
If yes, please explain.
Medical		First Aid Certified CPR Certified Lifeguard Certified EMT Certified Other
Medical Experience
Arts		Drama/Skits Stage/Props Costume Puppetry Crafts Painting Other
Arts Experience
Audio/Visual	*	Yes No
A/V Experience
Photography	*	Yes No
Photography Experience
Videography/Editing	*	Yes No
Videography/Editing Experience
PERSONAL TESTIMONY
Past Camp Experience (please describe your previous experience with overnight or day camps, either as a camper or volunteer):	*
Describe what makes you a Christian	*
Why do you desire to serve at Indian Hills Camp?	*
What missions experience do you have?
What evangelism experience do you have?
Please tell us about your current involvement with a local church (e.g. attendance frequency, involvement with church ministries, investment with community, etc.)	*
Describe your current relationship with God	*
How do you think God sees you?	*
Please describe your Spiritual Gifts and/or talents
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 we serve a wide variety of kids. 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 Staff 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 have been accused of any act of violence, neglect, abuse, or molestation of any child or adult?	*	Yes No
Engaged in or have been accused of any act of drug or alcohol abuse?	*	Yes No
Have you ever been convicted of anything other than a misdemeanor traffic violation?	*	Yes No
As far as you are aware:
Is there any circumstance or pattern in your life which would make it inappropriate 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", please explain in detail.
Read these commitments carefully, answer all of the questions, and initial in the small 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.	*
The IHC Training Session dates are from June 18, 2017 to June 22, 2017	*
In the event of acceptance, I am able to attend the IHC Training Session from June 18, 2017 to June 22, 2017	*	Yes No
List all conflicting dates during the IHC Training Session and the reason why you will not be present. If your answer to the previous question was yes, please write none.	*
The IHC contract dates are June 18, 2017 to July 9, 2017	*
If I am accepted, I am available and will commit myself to fulfill my contract dates starting June 18, 2017 and ending July 9, 2017.	*	Yes No
List all conflicting contract dates and the reason why you will not be present. If your answer to the previous question was yes, please write none.	*
I authorize all previous employers to furnish records, including the reasons for my leaving, and all information that they may have concerning me. I hereby release Shiloah Springs Bible Retreat, Inc. (AKA- 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 paperwork needed.	*
I am interested in participating at Indian Hills Camp this summer. I understand that the Summer Mission Project fee is $675.00 and have committed to raise that support and/or pay this fee.	*
REFERENCES
In order to move through the application process, Indian Hills Camp requires that you gather three references. Your references should not be family or relatives but instead, people who can speak to your fitness for the program. Please provide your reference's contact information and Indian Hills Camp will contact to submit their recommendation. Recommendations are required for acceptance into the program.
Reference Name	*
Reference Phone Number	*
Reference Email	*
Reference Name	*
Reference Phone Number	*
Reference Email	*
Reference Name	*
Reference Phone Number	*
Reference Email	*
By typing my name below, I, the Summer Mission Staff 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 dismal from the Summer Mission Project.
Applicant's Electronic Signature (please enter full name)	*
Today's Date	*
Security Code	*
Thank you for completing Step 1 of the Mission Staff Application Process for the Summer Missions Project 2017. 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. We will send an email to email address provided on the application with instructions on completing the application process.