Summer Staff Application

Full Name: *

Email: *

Cell Phone Number:

Camp Applying For: * Camp Mowana Lutheran Memorial Camp Camp Luther

Position Applying For: * Summer Staff Volunteer

Home Mailing Address: This is my preferred mailing address Please mail to my school address

Address:

City:

State:

Zip Code:

Home Phone Number:

College Mailing Address: This is my preferred mailing address Please mail to my home address

Address:

City:

State:

Zip Code:

College / Post High School Education: Currently enrolled Not enrolled

School Name:

Current Major:

City:

State:

Year in School: Freshman Sophomore Junior Senior Super Senior

Church Membership: Home congregation School congregation

Church Name:

City:

State:

Years Attended:

Pastor's Name:

Skills Inventory - Select any and all activities in each category below in which you have a moderate to high level of skill and experience. Hold down the "ctrl" key to select multiple skills in each category.

Sports:

Music:

Arts:

Outdoors:

Aquatics:

Leadership:

Support:

If you selected 'Other,' please explain:

References - Ask each reference to complete our online "Reference Form". Do not use relatives or peers. Include your pastor (if he or she is not related) and your most recent employer.

1.) Name:

1.) Relationship to you:

1.) Phone Number:

References - Ask each reference to complete our online "Reference Form". Do not use relatives or peers. Include your pastor (if he or she is not related) and your most recent employer.

2.) Name:

2.) Relationship to you:

2.) Phone Number:

References - Ask each reference to complete our online "Reference Form". Do not use relatives or peers. Include your pastor (if he or she is not related) and your most recent employer.

3.) Name:

3.) Relationship to you:

3.) Phone Number:

Employment / Volunteer Service - Include any jobs you've had in the last two years and preferably any jobs or volunteer experience where you worked with children.

1.) Employer:

1.) Position:

1.) Phone Number:

Employment / Volunteer Service - Include any jobs you've had in the last two years and preferably any jobs or volunteer experience where you worked with children.

2.) Employer:

2.) Position:

2.) Phone Number:

Employment / Volunteer Service - Include any jobs you've had in the last two years and preferably any jobs or volunteer experience where you worked with children.

3.) Employer:

3.) Position:

3.) Phone Number:

Please describe your reasons for wanting to work at camp: *

Additional Information

Have you ever been convicted of child abuse or a sexual offense? No Yes

If 'yes', please explain:

Have you ever been convicted of a felony? No Yes

If 'yes', please explain:

Certifications - Select any certifications you currently hold from the list below that will still be valid through the end of August of the upcoming summer. Hold down the "ctrl" key to select multiple certifications.

Certifications:

Position Preference

1st Position Preference:

2nd Position Preference:

3rd Position Preference:

I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this Application for Employment as may be necessary in arriving at an employment decision. I understand that neither this document nor any offer of employment from the employer constitutes an employment contract unless a specific document to that effect is executed by the employer and employee in writing. I understand that Ohio State law requires that my employment at camp be contingent upon passing a BCI/FBI background check. If hired, I give permission to the medical personnel selected by the camp to give emergency treatment for me in the event I am unconscious and my next of kin is unavailable. If hired, I give permission to use my photo in any LOMO camp promotional materials.

Digital Signature - By typing your full name and the date below you are providing us with a digital signature that binds to you the answers you gave above.

Full Name: *

Date: *

Once you have completed this application, and your three references has been submitted, a camp director will contact you to set up an interview. It is your responsibility to make sure that your three references complete the online reference forms in a timely manner. After you submit your form you will be re-directed to the LOMO homepage and a confirmation email will be sent to the email address you provided. If you experience technical difficulties when attempting to submit this form, please email Corey Wagonfield at: cwagonfield@lomocamps.org

Thank you for listening to your call to serve Lutheran Outdoor Ministries this summer!

Lutheran Outdoor Ministries in Ohio considers applicants for all positions without regard to race, color, sex, national origin, or non job-related disabilities. LOMO does, however, reserve the right to make employment decisions on the basis of an applicant's religious beliefs.

For information about our camps, visit us at: www.lomocamps.org