Staff Application 2021 Please enable JavaScript in your browser to complete this form.Applicant Information - Step 1 of 8Name *FirstMiddleLastGender *MaleFemaleBirthdate *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *Are you CPR / First Aid Certified? *Are you willing to Volunteer? *Are you willing to receive a background check? *Have you ever been convicted of a crime or do you currently have a charge pending? *YesNoIf yes, please explain:What positions are you applying for? Select all of the positions you would like to be considered for. *Head Counselor (21+)Counselor (18+),CIT (16-18)Float Staff (17+)BaTL (14-16)Cook’s Assistant (18+)NurseBunny Counselor (18+)Program Assistant (18+)BaTL Director (18+)Have you ever worked for Bliss? *YesNoIf yes, when / what position?How or from whom did you hear about a job at Bliss Summit? *What weeks are you available to be at camp? *Staff Training (required): June 28-30Discovery Camp: June 30-July 2 (6-9yr)Day Camp: July 5-9 (8-13yr)Adventure Camp: July 11-16 (10-13yr)Fusion Camp: July 18-23 (8-14yr)Junior Camp: July 25-30 (8-12yr)Teen Camp: August 1-6 (13-17yr)What is your t-shirt size?x-smallsmallmediumlargex-largexx-largeotherNextEmergency ContactName *FirstLastRelationship *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *PreviousNextHigh School *High School AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeFrom:To:Have you graduated? *YesNoHave you attended college? *YesNoCollegeCollege AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeFrom:To:Have you graduated? *YesNoDegree(s)Do you have any other education to report?YesNoOther EducationAddress (other education)Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePreviousNextPlease list 3 references. 1 Professional, 1 Personal (non-relative), 1 Spiritual (Pastor/Youth Pastor/Spiritual Mentor)1st referenceName (1st reference) *FirstLastRelationship (1st reference) *Email (1st reference) *Phone (1st reference) *Company (1st reference)2nd referenceName (2nd reference) *FirstLastRelationship (2nd reference) *Email (2nd reference) *Phone (2nd reference) *Company (2nd reference)3rd referenceName (3rd reference) *FirstLastRelationship (3rd reference) *Email (3rd reference) *Phone (3rd reference) *Company (3rd reference)PreviousNextHave you had any previous / current employment? *YesNoCompanyJob title and responsibilities:PhoneAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHow long did you work here (include dates)? If you are not currently working here, what was your reason for leaving?May we contact your previous supervisor for a reference?YesNoSupervisorFirstLastDo you have any other employment to report? *YesNoCompany (2)Job title and responsibilities: (2)Phone (2)Address (2)Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHow long did you work here (include dates)? If you are not currently working here, what was your reason for leaving? (2)May we contact your previous supervisor for a reference? (2)YesNoSupervisor (2)FirstLastPreviousNextI certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.Todays Date *Signature *Clear SignaturePreviousNextOur mission at Bliss Summit is three-fold: Evangelism, Growth, and ServiceOur vision is that Bliss Summit staff and volunteers will use Scripture, relationships, and creative programming to guide children and young adults along their spiritual journey.What church do you attend: *Pastor's Name *FirstLastPastor's Phone *Pastor's Email *Are you a member? *How often do you attend? *Sun. AM / Sun. PM / Prayer Meeting / Small Group / OtherHave you accepted Jesus as your Savior and how (and what age) did you come to the realization that you needed a Savior? * Click or drag a file to this area to upload. If asked by a child, how might you explain the path to salvation (please be specific)? * Click or drag a file to this area to upload. Have you proclaimed your salvation through Baptism? When? *Are you involved in any ministries (in or outside of your church) and what is your role in each? *What strengths did God bless you with and are you currently using any of those strengths to serve God? (Give at least two) *In what areas is God currently growing / stretching you? *Why do you want to work / volunteer at Bliss Summit this summer? *Please ask at least 3 people to pray for you while you serve this summer. (Please list those 3 people) *Will you commit to begin praying intentionally for your spiritual growth this summer, the growth of your campers and their families? *Our mission and vision statements are at the top of this page; how do you think God has equipped you to help us accomplish these this summer? PreviousNextAt Bliss Summit, as a ministry of BCM International, we believe and are committed to the following:Statement of Faith:- We believe in the Word of God – verbally inspired and inerrant in the original writings.- We believe in the total depravity of man.- We believe in the incarnation, deity, vicarious atonement, resurrection, and imminent coming again of our Lord Jesus.- We believe that salvation is the gift of God, received by personal faith in Jesus Christ as Lord.- We believe that God has called all believers to a life of holiness.- We believe that the command of Jesus Christ to preach the Gospel to every person is still each believer’s responsibility.Core Values:- We are committed to hold the Word of God central in all that we do.- We are committed to creating environments that lead to decision making encounters with the God of the universe.- We are committed to training our staff in biblical knowledge, ministry advancement, leadership, and practical life knowledge.- We are committed to ministering the grace and hope of our Lord Jesus Christ to everyone who we come in contact with.- We are committed to reaching every child possible, regardless of race, creed, financial situation, social status, etc…Disclaimer and SignatureI certify that I have read the above statements and am in agreement with them and will do my best to uphold them and honor the Lord with my service if I am blessed with the opportunity to serve at Bliss Summit this summer.Signature *Clear SignatureSubmit