Tri-Presbytery Counselor Form

TRI-PRES CAMP APPLICATION - JUNIOR or SENIOR COUNSELOR

Application must be received by the screening Committee
for consideration before July 1, 2010

Name ______________________________________________________________________________

Age: (Circle one): 14     15     16     17     18     19     20-30     31-40     51-60     60+

Address _____________________________________________________________

City____________________ State _____ Zip Code ________ Phone ____________

E-Mail______________________________________________________________

Gender: (Circle one)    Male or  Female

Church you attend ________________________ Are you a member?  Yes   No

How frequently do you attend? ____Weekly _____ Frequently _____ occasionally

Please explain any previous experience working as a counselor for junior age children or any other experience working with this age group.
______________________________________________________________________________________________________________________________________

Skills you can offer: (lifeguard, nursing, waterfront, crafts, etc) _________________________________

Do you have any current certification in any of the above skills?  Yes   No  Please list: _____________________________________________________________________________________________________________________________________

Name two personal references (not a relative or your pastor):

            Name ___________________________________________ 

            Address _________________________________________

            City ____________________ State_____ Zip Code_______

            Phone ____________________ Relationship ____________

            Name ___________________________________________

            Address _________________________________________

            City ____________________ State_____ Zip Code_______

            Phone ____________________ Relationship ____________

Do you feel that you are spiritually mature enough to set a positive Christian example for the campers?

 Yes    No   Explain: ______________________________________________________________________________________________

Is there any sin in your life which should prohibit you from serving as a counselor?   Yes    No

Can you honestly say you wish to serve as a counselor out of a sincere interest and desire to serve God?

Yes   No   Explain: _________________________________________________________________________________________________________________________________________

Explain how someone becomes a Christian. Supply Scripture references.

__________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________

What has God been teaching you recently?

 __________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________

Briefly explain your relationship with Christ:

__________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________________________

            I am willing to abide by the rules set down by Summit Lake Camp and the Tri-Pres Camp Committee.  I am willing to submit to a personal interview by someone on the Tri-Pres Camp Screening Committee if deemed necessary.  I recognize the Tri-Pres Screening Committee must approve my application and that by submitting an application, I will not automatically be accepted on staff.  I also understand that I must follow leadership of the Tri-Pres Camp Committee.  I have never been convicted of a sexual crime.  I further attest that all the above information is true and accurate.

Applicant's Signature: _______________________________________ Date _____________________

Please mail this completed application to the address below and have your Pastor complete the Pastor's Reference form. He will then complete the form and mail it to the Tri-Pres Camp Committee at the following address:

Tri-Pres Camp @ Bill Beans  1193 Latrobe Drive  Annapolis, MD 21409

 or E-Mail to beansii@verizon.net