I want to be a ...
VOLUNTEER PAID STAFF MEMBER Kitchen Staff
I want to be at ...
Kids Kamp July 3 - 7 Family Camp July 14 - 29 Young Adult Camp Aug 3 - 5 Youth Camp Aug 6 - 11
Position desired ...
Counselor Kitchen Worker Custodial Nursery Administration
Applicant information
First Name *:
Last Name *:
Birth Date:Month *:
Jan
Feb
Mar
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day *:
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Year *:
Marital Status *:
Spouses Name *:
Mailing Address
Address *:
City or Town *:
Province *:
NL
NS
NB
PE
QC
ON
MB
SK
AB
BC
YK
NT
NU
Postal code *:
Phone Number *:
Email Address *:
Home Church
Church Name *:
Pastor *:
Occupational Information
Social Insurance Number (optional):
Occupation and Employer *:
In Case of Emergency
Emergency Contact * :
Emergency Phone * :
Other
Do you have children? Yes : No :
If yes, is childcare arranged while at camp? Yes : No :
Have you recently used tobacco or illegal drugs? * Yes : No :
Why do you want this ministry? *
How long have you attended your assembly? Are you a member? *
Where and when did you accept Christ as your personal Savior *
List all churches you have attended regularly in the last 5 years. Indicate the church name, pastor, denomination and phone number *
Please indicate any previous or present ministry involvement. List the church, supervising pastor, and the capacity in which you minister *
Have you ever been convicted of a criminal offense? *
Yes : No :
Have you ever been convicted of a sexually related crime? *
Yes : No :
Have ever been hospitalized or treated for alcohol or substance abuse? *
Yes : No :
Do you have a communicable disease? *
Yes : No :
Are you in treatment for a form of mental illness? *
Yes : No :
Do you have any physical limitations that would prevent you from performing certain types of activities (ie.: lifting, bending etc.)? *
Yes : No :
Please list three (3) personal references. 18 years and over, not pastors or relatives. Please indicate their full name, address and telephone number *
Please record any information about your character, conduct, personality or history that could have influence on you ability to serve at a Chrisitan Camp
Applicants Statement
The information I have provided in this application is correct, to the best of my knowledge. I hereby authorize any references listed in this application to give any information that they may have concerning my suitability for this position. I release all such references from liability for any damage that may result in giving such evaluation.
I will attend all meetings relevant to my employment or volunteering. I will submit to each District authority.
I agree to be bound by the policies, philosophies, and directives of the Maritime District of the Pentecostal Assemblies of Canada regarding this event. I understand that law officials may access this information, under warrant, if requested.
I have read, and will adhere to, the Maritime District Child Protection Policy.
Yes, I Agree
IMPORTANT
Please do not arrive at Camp Evangeline for involvement unless you have been notified of your acceptance. You will be notified ONLY if you are accepted. Please attach an original copy of your Criminal Record Check. Mail this form to: Camp Evangeline, Box 1184, Truro, NS, B2N 5H1.
Volunteer & Staff Application