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1
Contact Information
2
Personal History
3
Employment Interests
4
Work Experience
5
Spiritual Insight
6
Employment Commitment
7
References
8
Name
*
First
Last
Address
*
Address Line 1
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City
State / Province / Region
Postal Code
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China
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Country
Primary Phone
*
Secondary Phone
Email
*
Primary Social Media Site URL
Example https://www.facebook.com/HartlandCamp
Are you a U.S. Citizen?
*
Yes
No
Do you have a Social Security Card?
*
Yes
No
Do you have a Driver's License?
*
Yes
No
No, but I will have one prior to summer
Date of Birth
*
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Gender
*
Male
Female
Marital Status
*
Single
Married
Divorced
T-Shirt Size (for uniform)
*
Small
Medium
Large
X Large
XX Large
XXX Large
Attach a recent picture of yourself (optional)
Click or drag a file to this area to upload.
Next
Hartland adheres to a policy prohibiting staff from using tobacco products of any kind, vaping, drinking alcohol, and using narcotics. If hired, do you agree to refrain from these activities both on/and off Hartland property?
*
Yes
No
Education Status
*
High School Student
High School Graduate
College Student
College Graduate
Other
Other: Please explain
I am a
*
Freshman
Sophomore
Junior
Senior
Name of School you are attending
*
Name of College
*
Major
*
Degree
*
Previous
Next
Employment Interests
*
1st Choice
Accommodations (housekeeping)
Counselor
Food Service
Lifeguard/Accommodations
Maintenance
Office Assistant
Program/Recreation
Videography/Photography
Employment Interests- 2nd Choice
2nd Choice
Accommodations (housekeeping)
Counselor
Food Service
Lifeguard/Accommodations
Maintenance
Office Assistant
Program/Recreation
Videography/Photography
Employment Interests- 3rd Choice
3rd Choice
Accommodations (housekeeping)
Counselor
Food Service
Lifeguard/Accommodations
Maintenance
Office Assistant
Program/Recreation
Videography/Photography
Position
*
I am willing to serve in any position available
I am only interested in the position(s) indicated above
Paid or Volunteer
*
I am only interested in paid positions
I am interested in volunteer positions
I am willing to consider either option
I can begin working on:
*
Summer employment typically begins in early June.
I can stay until
*
Summer employment typically ends in late August, but we will work with you to accommodate your schedule whenever possible.
Additional comments regarding start/end dates
Do you have limitations or disabilities that we should take into consideration?
*
Yes
No
If yes, please explain and suggest how we could accommodate you.
Previous
Next
Please list any current licenses or certifications (Please include expiration dates): (Food Handler Certification, Lifeguard Training, CPR, First Aid, RN, EMT, etc.)
I am currently
*
Employed (full-time)
Employed (part-time)
Unemployed
Employment Record
List any paid and/or volunteer positions you have held (most recent employment first).
Employer/Company Name
Name of Supervisor
First
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Phone
Your Job Title
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Checkboxes
I'm still employed here
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Add another employer
Employer/Company Name
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Add another employer
Employer/Company Name
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Add another employer
Employer/Company Name
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Reason for leaving
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Describe your current relationship with Christ. When did you become a Christian? What is your current participation in church and ministry activities?
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What do you actively/presently do to maintain your spiritual growth?
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In a few sentences, explain the Gospel
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What would you tell someone if they asked, "How does a person get saved?"
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What is discipleship? What is accountability? How are you personally experiencing both?
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Church attendance
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I attend church regularly (3+ times per month)
I am not currently attending a church
Name of the church you attend
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Number of years attended
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Pastor's Name
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Church Phone
In Matthew 20:25-28 (NIV), we read "Jesus called them together and said, “You know that the rulers of the Gentiles lord it over them, and their high officials exercise authority over them. Not so with you. Instead, whoever wants to become great among you must be your servant, and whoever wants to be first must be your slave— just as the Son of Man did not come to be served, but to serve, and to give his life as a ransom for many.” How do you see these words of Christ applying to the staff in a Christian camp?
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Why do you want to serve at Hartland Christian Camp specifically (instead of doing something else this summer)?
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What do you see as your strengths and weaknesses?
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Explain how you will focus on being a servant both to fellow staff and campers this summer. (This summer's focus is on others, not self)
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Employment Commitment
Staff members are encouraged to attend chapel services and Bible studies. Tidy living quarters and neat personal appearance while on the job are mandatory. Smoking and the use of alcoholic beverages and drugs are prohibited. Hartland staff will work approximately 40 to 48 hours per week. Camp staff schedules are dictated by the individual programs and the need to supervise kids 24 hours a day while camp is in session. If under 18 years old and you have not graduated from high school, you will need to show proof of a work permit before being hired. All staff members must agree to abide by the guidelines defined in the Summer Staff Handbook. Please read and respond to each of the following statements.
If employed, I would consider it a privilege to perform any responsibilities assigned to me by Hartland Christian Camp.
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Yes
No
If employed, I will commit myself to fulfill my commitment start and end dates.
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Yes
No
I understand that I may be called upon to serve as a counselor or to supervise campers/guests and am willing to serve in this capacity if needed.
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Yes
No
I authorize investigation of all statements herein and release Hartland Christian Camp, its directors, officers, and employees from liability in connection with same. I understand that, if employed, I will be an at-will employee. I also understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery.
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Yes
No
Voluntary Disclosure Statement
List previous residence(s) for last five years. Include colleges and home residence(s). List most recent address first.
Previous Address #1
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Add another address
Add another address
Previous Address #2
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Add another address
Add another address
Previous Address #3
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Add another address
Add another address
Previous Address #4
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Add another address
Add another address
Previous Address #5
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Have you ever been convicted of any of the following crimes
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Indecent assault and battery
Any crime relating in any manner to children and/or your conduct with them
Rape
Assault
Kidnapping
Distribution and trafficking of narcotics or other controlled substances
Intent to commit any of the above crimes
None of the above
Have you ever been adjudged liable for civil penalties or damages involving sexual or physical abuse of children?
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Yes
No
Are you now or have you ever been subject to any court order involving sexual or physical abuse of a minor, including, but not limited to, a domestic order or protection?
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Yes
No
Have your parental rights (if applicable) ever been terminated for reasons involving sexual or physical abuse of children?
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Yes
No
Have you ever been convicted of any crime other than those listed above?
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Yes
No
If you answered yes to any of the previous questions, please explain.
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Personal Pastoral Reference
Enter the name and email of a Pastor, Youth Leader, or someone knowing your relationship with God. By listing the individuals below, you are authorizing them to provide Hartland Christian Camp with the information requested. You are releasing him/her from all liability in the sharing of this information. An email will be sent to the individual indicated below, where they will be directed to complete an online reference form.
Personal Reference Name
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First
Last
Email
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Employment Reference
To be completed by an Employer, Teacher, or someone who knows your work ethic, character, and abilities. By listing the individual below, you are authorizing them to provide Hartland Christian Camp with the information requested. You are releasing him/her from all liability in the sharing of this information. An email will be sent to the individual indicated below, where they will be directed to complete an online reference form.
Personal Reference Name (Employer, Teacher, etc.)
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First
Last
Email
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