Employee Info
Employee Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Social Security Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Date of Birth {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Age {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
T-Shirt Size {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Home or Mobile Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Home Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Home Church {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Pastor's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Length of time attending? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Info about when you worked here {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Job Position Info
For General Staff & Counselor - Must be at least 16 years of age.
For Lifeguard - Must have current CPR, First Aid, and Lifeguard certifications.
For Nurse - Must be CPR, First Aid, have medical training, and experience distributing medications.
List any additional skills or qualifications we should know about {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
Education Record
Education {binding ItemNumber}
Name of School {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Type of School {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Year Graduated {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Start Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Finish Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Work History
Employment {binding ItemNumber}
Name of Company {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
From {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
To {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Company Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Company Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Your Supervisor's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Reason For Leaving {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Your Position and Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Describe the work you performed {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
EMPLOYEE MEDICAL INFO
Medical Conditions (e.g. Asthma, recent injury)
Name of Condition
Symptoms
Treatment
Special Instructions
Medical Condition {binding ItemNumber}
Name of Condition {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Symptoms {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Treatment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Special Instructions {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Medication (e.g. Albuterol, Amoxicillin)
Medication
Dosage
Time for Dosage
Reason for Taking
Special Instructions
Medication {binding ItemNumber}
Medication {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Dosage {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Time for Dosage {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Reason for Taking {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Special Instructions {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
STANDARDS FOR MEDICATIONS
If I'm hired as a counselor I will turn in all medication to the camp nurse. I will not keep any medication in the cabin with the campers. This includes prescriptions, over-the-counter medicines, vitamins, Epi-pens, and inhalers.
Medical Allergies (e.g. Bee Sting, Pollen)
Allergy Type
Reactions
Reaction Time
Treatment
Allergy Type {binding ItemNumber}
Allergy Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Reactions {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Reaction Time {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Treatment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Food Allergies (e.g. Milk, Peanuts)
Food Type
Reactions
Reaction Time
Treatment
Food Type {binding ItemNumber}
Food Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Reactions {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Reaction Time {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Treatment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
MORE MEDICAL INFO
Family Doctor {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Doctor Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Doctor Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Emergency Info
Parent Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Parent Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Parent Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
This information is for the hospital in case of and emergency where you might not be able to provide us with your insurance details at that time.
Insurance Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Insurance Policy Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Insurance Group Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Insurance Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Other Insurance Info {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
In case of emergency, I understand that every effort will be made to contact me. If I cannot be reached, I hereby give Camp Penuel East the permission to act on my behalf in seeking emergency treatment for my child in the event that such treatment is deemed necessary by Camp Penuel East staff. I give permission to those administering emergency treatment to do so, using those measures deemed necessary. I release Camp Penuel East, staff and organization from liability in acting on my behalf in this regard so long as Camp Penuel East staff is not grossly negligent.
This consent serves as permission for treatment by ANY Hospital, emergency room, or medical personnel. I agree to pay for all services provided for my child in my absence.
Parent Signature if under 18 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Personal Life
You are to represent an acceptable Christian worker. This is a Christian camp and we hold each staff member to set a standard worthy of your calling. Your actions and words should bring only glory to God and encouragement to co-laborers.
Entertainment is always an issue. Movies, music and literature tastes vary from person to person and we understand this. However, during your stay here we ask you to keep this wholesome and clean. Smoking, alcohol and drug use are not tolerated.
You are not here for the purpose of pursuing a physical relationship with another person. You are here for the purpose of doing ministry and seeing souls saved, healed and delivered by the power of Jesus. Male and female staff members are forbidden to be alone in the cabins, dorm, the lake or any other area of our campus.
Remember the children we minister to come from a variety of home situations and are exposed to various types of often inappropriate relationships. We must walk in a manner that will please the Lord and express the true love of Jesus to each other and to the kids we are here to serve.
Timeliness
"If you can't be on time, be 15 minutes early." Every staff member must wear a wrist watch to be able to keep on time with our schedule. We pride ourselves in running a top-notch camp. In doing so we must make every effort to be on time for every event, chapel, devotion and mealtime. Everything runs smoother when every worker is in place and ready to go.
Our morning staff chapel starts at 7:00 AM everyday and is required for every campus staff member. Any counselor that is not staying in a cabin with kids is also required to attend daily morning chapel.
Tardiness will be dealt with severely. The first time you will be asked to explain and provide sufficient reason. If tardiness or absence is a continual problem, you may be let go
Phone Usage
You are NOT allowed to carry your cell phone during work hours or while your are on campus or at any activity area which includes the lake and pools. Your cell phone must remain in the dorm at all times while camp is in session. All counselors must NOT have a cell phone in their cabin while camp is in session and children are present on campus.
You are required to have a wrist watch to keep track of time while you are on campus during work hours. The clock on your cell phone CANNOT be used as a substitute for a watch since you are not allowed to carry them on campus.
There is a phone in our kitchen that may be used for personal calls. These calls must be made when you have no event obligation. Please respect others in regards to time spent on the phone. The office personnel will not relay messages to you except in the case of family emergencies.
Vehicles
Occasionally, staff members bring their own vehicles to camp. We understand it is your vehicle, however we have our rules. They are not to be driven around the campus while children are present and should not be driven by anyone other than the registered owner.
We do not replace or repair vehicles either. Camp vehicles are to be driven by approved staff members only.
Paychecks
DON’T APPLY - If you are just wanting to work here for a paycheck instead of serving others. If you feel like serving others is beneath you then leadership is probably beyond your reach.
ONLY APPLY - If you are here to serve the kids that come to this camp. If you are here to serve each other as brothers and sisters in Christ. If you are here to serve the leadership of this camp as they lead others to Jesus.
It is important for you to remember this is a ministry service not a regular job. We will provide you with free room and meals every week. We will also give you a paycheck every Friday, but every staff member is required to help clean and reset the entire campus for the next group every week before receiving their check.
Personal References
Reference {binding ItemNumber}
You must submit at least three personal references. Your references must not be a family member and at least one reference must be your current Pastor.
Reference Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Reference Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Reference Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Reference Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Relationship to you {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Years known {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
Please tell us why you desire to work with our camp? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
Please tell us by describing what are the areas of ministry you have served in before? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
Please tell us a with a short list of what are your strengths and weaknesses in ministry? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
PLEASE READ AND SIGN
By signing this, you are releasing Camp Penuel East and/or its associates to verify work history and personal references. I grant permission for pictures or video I may apear in to be used in any camp publicity. You are further agreeing to the full camp term, which was previously revealed to you. This is not a binding contract, nor is it any guarantee of an employment offer from Penuel, Inc. or any of its associates. Penuel, Inc. does not discriminate on the basis of race, color, age, sex or nation of origin.
Applicant Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}