Counselor in Training Application

Name *

First

Last

Referred by

Gender *

Date of Birth *

Age *

Email *

Permanent Address, City, State & Zip Code *

Cell Phone Number *

T-Shirt Size *

Parent/Guardian Name *

Parent/Guardian Cell Phone Number *

Parent/Guardian Email *

Do you have a driver's license? *

Yes
No

Driver's License # (if applicable)

What high school do you attend? *

What grade are you in?

What is your graduation year?

What leadership positions, sports, club, or activities are you involved in at school?

Current Employer

Current Employer Phone Number

Position Held & Responsibilities

Previous Employer

Previous Employer Phone Number

Position Held & Responsibilities

List three words that describe you (separate by commas). *

Describe your ideal work environment. *

How well do you work with your peers? *

How do you feel when you are corrected or given specific instruction regarding a task? *

How well do you work and relate to children? *

Why would you like to be a summer staff member at Sabine Creek Ranch? *

What do you consider to be your personal strengths and weaknesses? *

Choose all of the areas of camp work that you are most interested in. *

*Requires certification that will be offered at the Ranch.

Do you have any experience as a lifeguard? *

Yes
No

Are you currently certified? *

Yes
No

If selected to join our summer staff, would you be willing to become a certified lifeguard? *

Yes
No

List and describe any experience you have in any of the following: video, photography, retail sales, acting, arts, crafts, teaching, singing, playing an instrument, web design, writing, public speaking.

List any disabilities or limitations that would affect your personal safety or job performance. *

List any allergies, chronic illnesses, and prescribed medications that are taken regularly. *

*You must bring your own epi-pen to camp if you have reactions that may require an injection.*

Describe your conversion to Christ (include before you were saved, when you were saved, and where you are now). *

What church do you attend? *

In what ways are you involved at your church? *

Do you feel comfortable telling others about Jesus and leading them through the steps of salvation? Please explain. *

Reference #1 (cannot be a family member) *

First

Last

Appropriate persons might include employers, academic advisors, instructors, pastors, family friends, etc.

Phone Number *

Email *

Relationship for Reference *

Reference #2 (cannot be a family member) *

First

Last

Appropriate persons might include employers, academic advisors, instructors, pastors, family friends, etc.

Phone Number *

Email *

Relationship for Reference *