Volunteer Application Form

Camp YoliJwa Staff Application
ABOUT YOU...
Name *

First Name Last Name
Date of Brith *

Month Day Year
Will you be 18 years of age before your week of service? *

Yes No
Pennsylvania's new child protection law requires that employees and volunteers that are over 18 years of age and serve in direct contact with children, receive documented state and in some cases federal clearances. These clearances MUST be submitted to Camp YoliJwa before adults are accepted to serve in our youth camping programs.

For more information regarding PA state clearances CLICK HERE.
Have you served on YoliJwa staff before? *

Yes Returning Staff Member No, New to YoliJwa Staff
Male or Female (Check One) *

Male Female
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Have you continually maintained a Pennsylvania home address since 2010? *

Yes No
Phone Number with Area Code *
E-mail *
High School grade completed. (Select One if Applicable) *
College major & years completed if applicable. *
Employer, job title, responsibilities if applicable. *
Please state any physical conditions which would limit your involvement in the total camping program. *
Do you have any tattoos or body piercings (excluding ear) that will be visible during the week? If Yes please describe. *

ABOUT YOUR FAITH...
Have you accepted Jesus Christ as your personal Savior? *

Yes No
What year did you accept Jesus Christ as your personal Savior? *
Please share your testimony, including how you came to know Christ & what difference He has made in your life since you accepted Him. *
YoliJwa leaders are encouraged to model their faith through devotions, prayer, & by going to church. Honestly answer how you are doing in those areas:
I have a personal devotional time... *
What devotional material do you use? *
If given the opportunity, I would be able to lead... *

Room Devotional Group Prayer A Bible Study Someone to Christ using Scripture
Do you attend church regularly? *

Yes No
Name and location of church, how long you have attended and describe your involvement and any leadership positions (past or present) *
Have you participated in or been charged with any illegal acts or immoral behavior during the past year? If yes, please explain. *

Pastoral Reference

Each applicant MUST list a Pastoral reference so that we can verify information we have received through this application.

Please list your current Pastor's name, phone and email address (will be kept private). Camp staff will contact the reference below in order to provide further information.
Pastor's Name *

First Name Last Name
Pastor's phone number with area code *
Pastor's email address *
example@example.com
By signing below I, affirm that I have not been convicted of a felony or sex crime within the previous five years, will commit to pray for Camp YoliJwa's mission & needs, will follow the facility rules and regulations, will serve as a Christian role model with my life, will cooperate & respect camp leadership, and I will prepare for my service by knowing my responsibilities and attending all meetings. *

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Camp YoliJwa Staff Application