Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Sex: *

Male

Female

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Do you require proof of hours for a volunteer incentive program? *

Yes

No

Have you taken the Plan to Protect online course and have up-to-date certification? *

Yes

No

Yes, but not up-to-date

Personality *

Select all that apply

Cooperative

Dependable

Sense of humour

Poor self discipline

Lazy

Self starter/ motivated

Attitude *

Select all that apply

Usually positive

Sometimes negative

Try to please

Complacent

Critical

Puts the needs of others first

Lives by your own rules

Flexibility *

Select all that apply

Adjust quickly and easily to change

Change is difficult

Enjoy being challenged

Not assertive

Steps up when called upon

Spiritual Life *

Select all that apply

Steady and growing

Up and down

An inspiration to others

Rely on friends and family

Victorious

Able to apply biblical truth into situations

Non-existent

REFERENCES *

I hereby provide a list of the names and contact info of my pastor and two other acquaintances that are not relatives, who will give an objective evaluation of my character, abilities and work habits. If you do not have a pastor, please choose a close mentor or someone else in your life that is not a family member. Ask all of your references to complete the reference form. Name of Pastoral Reference

First Name

Last Name

Phone

(###)

###

####

Name of Personal Reference #1 *

First Name

Last Name

Phone

(###)

###

####

Name of Personal Reference #2 *

First Name

Last Name

Phone

(###)

###

####

I have been advised of my responsibilities and I understand that I will directly answer to the camp director(s). I agree to work in harmony with those around me and to abide by the rules, regulations, policies and procedures of the camp. *

Yes

No

I further understand that, given the sensitive nature of working with children, and expectations of society and regulatory bodies and insurers, Veteran Full Gospel Camp Association requires:

1. This application
2. Current references (One Pastoral & Two Personal)
3. If you are 18 years or older, a criminal record check (CPIC and VSV).

We will provide a letter requesting the check for you to take to your local RCMP, after you have been accepted. *

Yes

No