Apply to Serve | Indian Youth Camp

Name & Primary Contact Info

All required fields are marked with an *

First Name *

Last Name *

Phone *

Email *

Have you served as a staff member at IYC in the past 5 years? *

YesNo

Please note: If you have only previously served as Jr. Staff, please check No.

Personal / Contact Information

Has any of your personal/contact information changed since your last application?*

YesNo

Personal / Contact Information

Address

Address Line 2

City

State

Zip

Demographic Info

Gender *

Marital Status

Date of Birth

Address

Address *

Address Line 2

City *

State *

Zip *

Demographic Info

Gender *

Marital Status *

Date of Birth*

Emergency Contact Information

Do you want to update your emergency contact information?*

YesNo

Emergency Contact Information

First Name *

Last Name *

Relation *

Phone *

First Name

Last Name

Relation

Phone

Previous Camp Experience

Would you like to update your previous camp experience? * (i.e. other camps attended since last serving at IYC or comments specific to your latest staff experience at IYC.)

YesNo

Do you have any prior camp experience?* (either as a staff member or a camper)

YesNo

Prior IYC Staff Experience

Camp Experience Details *

Previous Camp Experience

Prior IYC Staff Experience

Camp Experience Details

Church Information

Do you attend the same church as listed on your previous year's application? *

YesNo

Church Name *

City*

Denomination*

Attendee Status *

Regular AttendeeChurch Member

Pastor Name

First Name *

Last Name*

Church Information

Church Name *

City*

Denomination*

Attendee Status *

Regular AttendeeChurch Member

Pastor Name

First Name *

Last Name*

Personal References

(Please do not use relatives - you may include pastors & employers.)

Do you want to update any of your personal references? *

YesNo

Reference #1

First Name *

Last Name*

Relationship*

Phone *

Reference #2

First Name *

Last Name*

Relationship*

Phone *

Reference #3

First Name *

Last Name*

Relationship*

Phone *

Personal References

(Please do not use relatives - you may include pastors & employers.)

Reference #1

First Name *

Last Name*

Relationship*

Phone *

Reference #2

First Name *

Last Name*

Relationship*

Phone *

Reference #3

First Name *

Last Name*

Relationship*

Phone *

Pastoral Approval & Signature

Pastor Name

You will not be considered for a staff position at IYC without your pastor's recommendation. Please provide the following information for the pastor who is best able to speak to your qualifications to work at IYC.

First Name *

Last Name*

Email *

Phone *

Acknowledgement

By checking this box:

I verify that all the information I have provided in this application is true and accurate.
I authorize Indian Youth Camp, Inc. to verify any/all information provided, as well as contact listed references.
I have read all of the IYC staff personnel policies and am willing to abide by them.
I understand that during the week of camp I will be given assignments to perform and am willing, if need be, to go beyond the duties of my specific job.
I understand there is risk of injury associated with activities and/or games during camp, and I agree not to hold Indian Youth Camp responsible for any injuries sustained while at camp.‍
I understand that pictures/videos will be taken during camp and give my permission for my image to be used for promotional materials (website, brochures, etc.) in highlighting camp.
I agree to complete Sexual Abuse Awareness Training and submit to a background check.

Signature

By entering your full name and today's date below, you are providing your digital signature for this application.

Full Name *

Date *

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Summer Camp Staff Application

Name & Primary Contact Info

Personal / Contact Information

Personal / Contact Information

Address

Demographic Info

Address

Demographic Info

Emergency Contact Information

Emergency Contact Information

Background Information

Background Information

Previous Camp Experience

Previous Camp Experience

Church Information

Pastor Name

Church Information

Pastor Name

Personal References

Reference #1

Reference #2

Reference #3

Personal References

Reference #1

Reference #2

Reference #3

Staff Position/Camp Information

Pastoral Approval & Signature

Pastor Name

Acknowledgement

Signature