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, 2008
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