St. Ann's Summer Camp Counselor Application

Address

PERSONAL INFORMATION
Hobbies
Special Interests
Have you ever been convicted of a felony or misdemeanor?

Yes No
If Yes, please explain
Are you currently under indictment or probation for any crime?

Yes No
If Yes, please explain
Have you ever been accused of or involved in any incident involving sexual or physical abuse of a child?

Yes No
If Yes, please explain
Please list any medical conditions.
Are you currently taking any medications? (Please list)

EDUCATIONAL BACKGROUND
High School (Name, City, Graduation Date)
College (Name, City, Graduation Date)
Other Education
What are your educational and career goals?
List some of your favorite and least favorite subjects in School.
EMPLOYMENT HISTORY

List the last three employers as follows
Employer (Company, Dates employed, Supervisor, Phone #, Responsibilities, Reason for leaving)
Employer (Company, Dates employed, Supervisor, Phone #, Responsibilities, Reason for leaving)
Employer (Company, Dates employed, Supervisor, Phone #, Responsibilities, Reason for leaving)

YOUTH EXPERIENCE
List activities, youth camps, or youth groups you have been involved with. What was your role?
Describe any previous experience you have had working with children between the ages of 6-17.
What are your strengths and weakness in working with children between the ages 6-17?
What are your gifts and talents? Which could be used in this camp. (Musical Talent, Arts & Crafts, Archery, etc)
Do you have any ideas of projects for the youth?
How did you hear about St. Ann's Summer Camp?

LIFE EXPERIENCES

In order to help our youth in the best way possible at St. Ann’s Summer Camp. We need to learn a little more about you: your strengths, gifts and talents, and experiences of life. This will enable us to evaluate the specific ways by which you will serve the youth. We deeply appreciate your desire to share a part of your life with the youth and with us as well. Please be open and honest in your answers.
Briefly describe your beliefs concerning the Catholic Church.
What role would you say Jesus plays in your life?
How do you think God sees you?
List any related activities or ministry you have been involved in.
How do you see yourself sharing your faith with the campers?
How will you share your faith with the staff?
Are there any issues with the Catholic Church that you struggle with?
What traits do you exhibit that make you a good Christian role model to others?
What does “spirituality” mean to you?
What do you believe is the best way to discipline a child?
What is child abuse?
What do you expect to get out of working St. Ann’s Summer Camp?
Please give a brief biographical sketch of your life as a Catholic (or a Christian), which includes such information as any growth you’ve gone through or experiences that taught you something important about God.

This next section is meant to provide us with some insight about your personal beliefs and values. So please describe your beliefs about the following topics honestly and candidly.
Use of Tobacco
Use of Alcohol
Use of illegal Drugs
Homosexuality
Premarital sex
Abortion
Pornography
I declare that all of the above information is true to the best of my knowledge. I give my permission for the personnel of St. Ann’s Catholic Church and St. Ann’s Summer Camp to confer with the references listed in this application, regarding my previous work history and performance or any other information that may be beneficial or pertinent.
Name/ Date
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In addition, to the application we also would likes 2 reference letters (No Relatives) and will be contacting you to have an interview.

Thanks for your interest in serving the youth of the Turtle Mountian

Reference letters may be mailed or emailed to:

Amanda Estabrook, PO Box 2000, Belcourt, ND 58316

soltvolunteersaintann@gmail.com
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