This form should take no more than 15 minutes to complete and submit.  Use your mouse or the Tab button to navigate this form.  We will acknowledge the receipt of your interest and after review by the senior staff, we will contact you.

First Name

Last Name

Date of Birth

Sex
I'm interested in the following ministry role this summer.

(Ctrl-click to choose more than one)
I'm interested in the following weeks
Permanent Home Address


City

State

Zip

Telephone

Cell Phone

Email

What is the best way to contact you?
  
   
Getting to know you better
School
Name of Current School

Class

Graduation Year

Major

 		 Work
Present/Most Recent Employer

What do you do?

Years of service
Church
What church do you presently attend?

How would you describe your church?

 		 Pastor or Youth Minister
Name

Telephone Number

Your pastor may be contacted as a reference.
 
Please use a couple of sentences to answer the following.
What is your relationship with God
 On what basis will you be allowed to enter heaven?
How have you grown spiritually in the last 12 months?
 What did you do last summer?
Why would you like to work at Camp Kanesatake?
  
   
By selecting "Yes" I attest that the information I have given is true and correct.