JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Counselor Application
Please complete all fields honestly, completely, and to the best of your ability.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
I have read the
Counselor Job Description
and can fulfill all the duties and requirements of this position.
*
Choose
Yes
No
First Name
*
Your answer
Last Name
*
Your answer
Will you have graduated from High School by July 1?
*
Yes
No
Required
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Age you will be on July 6
*
Choose
16
17
18
19
20
21
22
23
24 or older
Personal Cell Phone
*
(with area code)
Your answer
Home Phone (if applicable)
(with area code)
Your answer
Email Address
*
Your answer
Home Church
*
Your answer
Which best describes you:
*
I am a member of the above church.
I am a regular attender of the above church.
I am an occasional attender of the above church.
Required
Have you ever received Christ Jesus as your Personal Savior?
*
Yes
No
Not Sure
Required
If yes, at what age?
*
Choose
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30 or older
Please check the weeks of camp you are available to work:
*
(Preference will be given to those available for all weeks.)
Teen Camp, July 7-12
Discovery Camp, July 14-19
Adventure Camp, July 21-26
Lil' Squirts Day Camp, July 29-31
Required
Did you work as a counselor at Camp JYC this past summer?
*
Yes
No
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
