SSCYC, INC.

"A Vacation with a Purpose"

SUMMER CAMP

VOLUNTEER CAMP STAFF APPLICATION

PERSONAL INFORMATION

Full Name	First Name Middle Name Last Name Suffix
Pronouns	Please enter your pronouns.
Gender	Please enter your gender.
Current Address	Street Address
	City State Zip Code
	How long have you lived at this address? Year(s) Month(s)

Previous Address	Street Address
	City State Zip Code
	How long have you lived at this address? Year(s) Month(s)
Phone Numbers	Home Mobile
Email Address	Email Address
	Are you 18 years old or older?

EDUCATION

High School	School Name
	City State
	Have you graduated?
College	School Name
	City State
	Are you currently enrolled?
	Have you graduated?
	Degree or area of study?
	Number of years attended?
Other	School Name
	City State
	Are you currently enrolled?
	Have you graduated?
	Degree or area of study?
	Number of years attended?

REFERENCES

Please include at least one professional reference (employer, teacher, coach, advisor, etc.)
You should not use family or current camp staff as references.

Reference 1	Name Relelationship
	Street Address
	City State Zip Code
	Home Phone Mobile Phone
Reference 2	Name Relelationship
	Street Address
	City State Zip Code
	Home Phone Mobile Phone

GENERAL INFORMATION

Were you previously a camper at this summer camp program?

Are you an active member of one of the SSCYC member churches or a leader for their youth group?

Do you have any current certifications that may be relevant to this summer camp program? (Check all that apply)
CPR/First Aid
Lifeguard
Registered Nurse (RN)
Licensed Educator
ACA Certified
Other

List any of your skills/talents that may strengthen and support any aspect of this summer camp program.

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List any of your work experience/leadership skills that may enhance this summer camp program.

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List the 3 camp staff members that know you best.

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Have you ever been convicted of, or plead guilty to, a crime including, but not limited to, assault, sexual assault, or child abuse?

APPLICATION INSTRUCTIONS

Applications are current being accepted for the 2024 summer camp, August 17-23.

Please type your name below and review your digital signature.

By clicking "Submit Application", you declare that you are the named applicant and all information above is complete and accurate.

Print your name Date
Signature

Upon clicking "Submit Application" you will be taken to a confirmation page and a copy of the application will be sent to the address provied above.