Clone of First-Time Leader Application 2018

Servant-Leader Application

MCYA Youth Camp 2019
BEFORE completing this form, please read the “Before You Apply” file for the detailed explanation.

Thank you for taking the time to consider serving at MCYA’s Summer Youth Camp. Before, during, and after the application process, we invite you humbly submit yourself to prayer, as we will be doing the same. We look forward to learning about what God is doing in you!
First* Please click here to read: Before You Apply
Which Leadership Position are you applying for? (See description below) *

Coach Captain
Coach: a former participant of the MCYA youth camp preferred, Youth Leader, Pastor, or Mentor. Coaches are responsible for their Captain's emotional and spiritual well-being. They are expected to be great listeners and influential growth leaders. The qualities of a Coach include but are not limited to: embracing and practicing grace, patience, and forgiveness. The Coach carries the overarching vision of the MCYA organization and Coach's heartbeat is biblical discipleship.

Captain: The Captain is the front-liner, the high-spirited champion of the campers. They are always leading by example. Though the Captains are the heart of the team, they must be teachable. Captains should always take responsibility and be present with campers. They are accountable to their assigned Coach. Leading and growing should never be done alone. Captains are the pioneers, sometimes coming up with new ideas; encouraging ideas and championing them. Captains help carry the Mission!
Which age group would you prefer to serve? *

Junior High Senior High As Needed
Personal Information
Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Birthday *

Month Day Year Date Picker Icon
Gender *

Male Female
Marital Status *

Single Married Divorced Widowed
Educational Background: If still in school, where and what year?
Medical/Accident Insurance: Name and Policy#:
E-mail *
Phone Number *

Area Code Phone Number
Church Information
Are you a Christian? *

Yes No
Have you been baptized? *

Yes No
Do you attend church regularly? *

Yes No
Name of Church and Denomination
Pastor/Leader

Church Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number
Health and Emergency Information
Emergency Contact (other than listed parent/guardian)

In case of emergency, parents will be contacted first. If they cannot be reached, who should be contacted?
Name *

First Name Last Name
Relationship To You *

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

Area Code Phone Number
What is the condition of your health? *
Do you have any physical disabilities or health concerns that would limit your participation in activities? *

No Yes
If yes, please explain
In the event that you become seriously ill or injured on this mission, a camp nurse or director will bring your personal medical information to a doctor who will treat you. Is there anything a doctor should know about your physical condition or medical history? If Yes, please explain:
Please list all prescription medications you are taking (used for emergency medical info packet):
Please list all allergies (food and medical):
Faith Experience Questions
Please complete the following questions in two or three sentences:
Why would you like to serve with MCYA this summer? Why have you chosen the specific position? *
What is the gospel? *
What does being a Christian mean to you? *
Share your experiences of being part of a team, both highs & lows. *
Please check the areas that you have experience in: *

Leading Small Groups Working with Youth Teaching Bible Study Youth Activities Discipleship Sharing the Gospel Missions Praise and Worship Leading
Self Evaluation Scale: Evaluate yourself with respect to the following characteristics. Choose the appropriate number using a number scale of:

5 = Exceptional, 3 = Average, 1 = Needs work
Commitment to Christ *
Listening Skills *
Flexibility *
Dependability *
Cooperation with others *
Organization *
Communication Skills *
Willingness to be open *
Taking initiative *
Appreciation of diversity *
Sensitivity *
Patience *
Confidence *
Self-awareness *
References
Please list the following as your reference:

1) A peer or friend who knows you and your faith background well

2) Your Pastor or Youth Pastor/Leader within your community of faith

These two individuals will be contacted as part of your application process. Please let them be aware of this.
Spiritual Reference Contact: *

First Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
How long have you known this person?
Peer/Friend Reference Contact: *

First Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
How long have you known this person?
Background and Liability
Have you ever been arrested or convicted for any offense other than a minor traffic violation? If yes, please explain during interview. *

Yes No
Have you ever been accused, arrested, or convicted for any sexually related crimes? If yes, please explain during interview. *

Yes No
Are there any other circumstances involving your life-style or background that would call into question your ability to work with youth? If yes, please explain during interview. *

Yes No
Click here to review the MCYA Leadership Covenant *right click and open on new tab
If accepted as a leader with MCYA, I am willing to abide by the rules and policies of the MCYA Leadership Covenant and Mt. Hope Bible Camp. *

Yes No
Signature *

Please use your mouse to draw your signature. Clear
Don't forget to click.... SUBMIT!!!!
Congratulations!

You have completed Step 2 of your Leadership Application!

We will be in contact with you as soon as we review your application.

Please review the next steps to completing your application! :)
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Servant-Leader Application

BEFORE completing this form, please read the “Before You Apply” file for the detailed explanation.