PARADISE POINT SUMMER CAMP
PARADISE POINT SUMMER CAMP The Episcopal Diocese of Idaho McCall, ID
2017 VOLUNTEER APPLICATION GENERAL INFORMATION Last Name
First Name
Occupation
Birth date
T-Shirt Size
Gender
Age
Current Address
City
Primary Phone ( )
Alternate Phone ( )
Email
Driver’s License #
State
ZIP Code
Issuing State:
Volunteer Position Applying For (Nurse, Clergy, Dean)
Please check which camp(s) you would like to volunteer for: Ultimate Adventure: June 18-24 Water Week: July 16-22 Youth Horse Camp: June 18-24 Teen Camp: July 23-29 . Extreme Adrenaline: July 9-15 Teen Horse Camp: July 30-August 4
Mountain Adventure I: July 30-August 4 Mountain Adventure II: July 30-August 4 Beginner’s Camp: July 31-August 3
Have you ever been charged or convicted of any crime other than a minor traffic violation?
Y or N
Note: A conviction may not automatically disqualify the applicant from volunteer work.
If yes, please explain: Religion/Denomination (not required)
Home Church (not required)
EMPLOYMENT HISTORY Beginning with your most recent employer, please list your past three jobs. 1. Employer Name
Job Title
Dates Employed
Job Title
Dates Employed
Job Title
Dates Employed
Reason for leaving 2. Employer Name Reason for leaving 3. Employer Name Reason for leaving
Return to: Robyn Hatfield 1858 W. Judith Lane, Boise, ID 83705 – Fax 208-345-9735 Email: [email protected]
Revised 01/17
HEALTH INFORMATION A completed health form is required of all volunteers after being selected. Do you have any physical, mental, or emotional limitations that might interfere with your ability to perform the position you are applying for? Y or N If yes, please describe:
Emergency Contact:
Cell:
Home:
Please notify the camp if you become exposed to a communicable disease within three weeks prior to camp session.
REFERENCES Please list three non-family references. Relationship to You
Name
Email Address
Why You Chose This Reference
1. 2. 3. 4. Spiritual Reference (not required)
ACTIVITY INFORMATION Current Certifications: (CPR, First Aid, WSI, Life Guard, Belay Trained, etc.) Interests and Special Abilities (sports, instruments, skills, etc.)
VOLUNTEER PERSONAL QUESTIONS If you are a NEW volunteer applicant at Paradise Point, please answer the following questions on a separate sheet of paper. If you have previously volunteered at Paradise Point, please skip to the next section.
1. Why would you like to volunteer at camp? 2. Do you have any previous experience working with children? 3. What do you see as your spiritual gifts? How will you use your spiritual gifts at Paradise Point?
STATEMENT OF COMMITMENT Paradise Point is a ministry of The Episcopal Church and we seek to create an inclusive and supportive Christian community at camp. Volunteers are role models to youth, participate in worship services and are actively engaged in Christian formation and learning with the campers and staff members. I understand that working at Paradise Point requires living in a Christian community and following the rules of camp is of utmost importance. I understand that while volunteering at Paradise Point, I am there for the campers and their experience and will maintain a safe, clean and productive working and living environment. I understand that the use of alcohol, tobacco, or drugs is PROHIBITED by ALL VOLUNTEERS at ALL TIMES. I certify that my answers are true and complete to the best of my knowledge. In the event of being given a volunteer opportunity, I understand that false and misleading information given in my application or interview may result in discharge.
Applicant’s Signature:
Date Signed:
Return to: Robyn Hatfield 1858 W. Judith Lane, Boise, ID 83705 – Fax 208-345-9735 Email: [email protected]
Revised 01/17
APPLICANT BACKGROUND INFORMATION Protective Services Check - Criminal Records - Motor Vehicle Check – Credit Check
Full Name (First, Middle, Last): Date of Birth:
Social Security:
Alias (if applicable): Driver’s License #:
State or issuing jurisdiction:
Please list location of school and home residences for the past 10 years (current & most recent first). Address, City, State, Zip Code County Area Code Dates of Residence
Address, City, State, Zip Code
County
Area Code
Dates of Residence
Address, City, State, Zip Code
County
Area Code
Dates of Residence
1) Have you ever been convicted or charged with a crime related to attempted or actual misconduct with a child including but not limited to sexual abuse, child abuse, sexual exploitation, and child neglect? Y or N If yes, please explain:
2) Have you ever been convicted or charged with a violent crime against children or adults including but not limited to rape, assault and battery, kidnapping, or intent to commit these crimes? Y or N If yes, please explain:
3) Have you ever been held liable in a civil case regarding the above mentioned crimes? If yes, please explain:
Y or N
4) Have you ever been terminated from a job, arrested or convicted of a crime due to illegal drug use or involvement in illegal drug related activities? Y or N If yes, please explain:
I hereby authorize the agency chosen by Paradise Point to provide the requested information. I understand that Paradise Point has a practice of requesting a background check, which could include protective services check/criminal records/motor vehicle check/ credit check on prospective staff members and volunteers. I hereby grant permission and authorize the above-mentioned checks and give permission to allow verification of any information given on my application. I understand that failure to provide accurate information may result in nullification of offer or termination. I also understand that Paradise Point may deny/terminate employment if I answered “yes” to any of the four questions I was asked on this form or if Paradise Point discovers any information that may imply a “yes” to any of the questions. I understand that the information obtained will become part of my employment or volunteer application and will be on file in the business office of The Episcopal Diocese of Idaho.
Staff Member/Applicant Signature:
Date:
Parent/Guardian Signature (if under 18):
Date:
Return to: Robyn Hatfield 1858 W. Judith Lane, Boise, ID 83705 – Fax 208-345-9735 Email: [email protected]
Revised 01/17
2017 VOLUNTEER APPLICATION GENERAL INFORMATION Last Name
First Name
Occupation
Birth date
T-Shirt Size
Gender
Age
Current Address
City
Primary Phone ( )
Alternate Phone ( )
Driver’s License #
State
ZIP Code
Issuing State:
Volunteer Position Applying For (Nurse, Clergy, Dean)
Please check which camp(s) you would like to volunteer for: Ultimate Adventure: June 18-24 Water Week: July 16-22 Youth Horse Camp: June 18-24 Teen Camp: July 23-29 . Extreme Adrenaline: July 9-15 Teen Horse Camp: July 30-August 4
Mountain Adventure I: July 30-August 4 Mountain Adventure II: July 30-August 4 Beginner’s Camp: July 31-August 3
Have you ever been charged or convicted of any crime other than a minor traffic violation?
Y or N
Note: A conviction may not automatically disqualify the applicant from volunteer work.
If yes, please explain: Religion/Denomination (not required)
Home Church (not required)
EMPLOYMENT HISTORY Beginning with your most recent employer, please list your past three jobs. 1. Employer Name
Job Title
Dates Employed
Job Title
Dates Employed
Job Title
Dates Employed
Reason for leaving 2. Employer Name Reason for leaving 3. Employer Name Reason for leaving
Return to: Robyn Hatfield 1858 W. Judith Lane, Boise, ID 83705 – Fax 208-345-9735 Email: [email protected]
Revised 01/17
HEALTH INFORMATION A completed health form is required of all volunteers after being selected. Do you have any physical, mental, or emotional limitations that might interfere with your ability to perform the position you are applying for? Y or N If yes, please describe:
Emergency Contact:
Cell:
Home:
Please notify the camp if you become exposed to a communicable disease within three weeks prior to camp session.
REFERENCES Please list three non-family references. Relationship to You
Name
Email Address
Why You Chose This Reference
1. 2. 3. 4. Spiritual Reference (not required)
ACTIVITY INFORMATION Current Certifications: (CPR, First Aid, WSI, Life Guard, Belay Trained, etc.) Interests and Special Abilities (sports, instruments, skills, etc.)
VOLUNTEER PERSONAL QUESTIONS If you are a NEW volunteer applicant at Paradise Point, please answer the following questions on a separate sheet of paper. If you have previously volunteered at Paradise Point, please skip to the next section.
1. Why would you like to volunteer at camp? 2. Do you have any previous experience working with children? 3. What do you see as your spiritual gifts? How will you use your spiritual gifts at Paradise Point?
STATEMENT OF COMMITMENT Paradise Point is a ministry of The Episcopal Church and we seek to create an inclusive and supportive Christian community at camp. Volunteers are role models to youth, participate in worship services and are actively engaged in Christian formation and learning with the campers and staff members. I understand that working at Paradise Point requires living in a Christian community and following the rules of camp is of utmost importance. I understand that while volunteering at Paradise Point, I am there for the campers and their experience and will maintain a safe, clean and productive working and living environment. I understand that the use of alcohol, tobacco, or drugs is PROHIBITED by ALL VOLUNTEERS at ALL TIMES. I certify that my answers are true and complete to the best of my knowledge. In the event of being given a volunteer opportunity, I understand that false and misleading information given in my application or interview may result in discharge.
Applicant’s Signature:
Date Signed:
Return to: Robyn Hatfield 1858 W. Judith Lane, Boise, ID 83705 – Fax 208-345-9735 Email: [email protected]
Revised 01/17
APPLICANT BACKGROUND INFORMATION Protective Services Check - Criminal Records - Motor Vehicle Check – Credit Check
Full Name (First, Middle, Last): Date of Birth:
Social Security:
Alias (if applicable): Driver’s License #:
State or issuing jurisdiction:
Please list location of school and home residences for the past 10 years (current & most recent first). Address, City, State, Zip Code County Area Code Dates of Residence
Address, City, State, Zip Code
County
Area Code
Dates of Residence
Address, City, State, Zip Code
County
Area Code
Dates of Residence
1) Have you ever been convicted or charged with a crime related to attempted or actual misconduct with a child including but not limited to sexual abuse, child abuse, sexual exploitation, and child neglect? Y or N If yes, please explain:
2) Have you ever been convicted or charged with a violent crime against children or adults including but not limited to rape, assault and battery, kidnapping, or intent to commit these crimes? Y or N If yes, please explain:
3) Have you ever been held liable in a civil case regarding the above mentioned crimes? If yes, please explain:
Y or N
4) Have you ever been terminated from a job, arrested or convicted of a crime due to illegal drug use or involvement in illegal drug related activities? Y or N If yes, please explain:
I hereby authorize the agency chosen by Paradise Point to provide the requested information. I understand that Paradise Point has a practice of requesting a background check, which could include protective services check/criminal records/motor vehicle check/ credit check on prospective staff members and volunteers. I hereby grant permission and authorize the above-mentioned checks and give permission to allow verification of any information given on my application. I understand that failure to provide accurate information may result in nullification of offer or termination. I also understand that Paradise Point may deny/terminate employment if I answered “yes” to any of the four questions I was asked on this form or if Paradise Point discovers any information that may imply a “yes” to any of the questions. I understand that the information obtained will become part of my employment or volunteer application and will be on file in the business office of The Episcopal Diocese of Idaho.
Staff Member/Applicant Signature:
Date:
Parent/Guardian Signature (if under 18):
Date:
Return to: Robyn Hatfield 1858 W. Judith Lane, Boise, ID 83705 – Fax 208-345-9735 Email: [email protected]
Revised 01/17
