Riverside 2021 Summer Staff Application
Thank you so much for applying to work at Riverside this summer! You will not be able to close out of this application and return to it at a later time, so be sure that you have 30-40 minutes to complete the application. Otherwise you will have to start over. It is helpful to write your answers to the essay questions in another document, so that way you have them saved in case the internet crashes on you. If you would rather fill out a paper copy of the application, those can be found on our website at https://www.riversidelbc.org/applications-summer-staff. Contact Lute Olson at Lute@RiversideLBC.org with any questions or concerns.
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Email *
First Name *
Middle Initial *
Last Name *
Preferred Name (if different than first name)
I certify that by June 2021, I will be at least one full year out of High School. *
Phone Number *
Please indicate if this is your cell or home phone (i.e. 111-111-1111 Cell)
Gender *
I am applying for... *
Required
Dates available to work... *
(i.e. May 30 - August 13) (Staff training begins May 30, and our last day of camp is August 13.)
Current Address (include City, State, and Zip) *
(i.e. 3001 Riverside Rd. Story City, IA 50248)
Is this your home or school address? *
How long have you lived at this address? *
Alternate Address (include City, State, and Zip)
Is this your home or school address?
Clear selection
For what dates will you be living at the alternate address?
How long have you lived at this address?
What is your father's name? (First and Last) (Please indicate if deceased) *
What is your father's phone number? *
What is your father's email address? *
What is your mother's name? (First and Last) (Please indicate if deceased) *
What is your mother's phone number? *
What is your mother's email address? *
What is the name of your home church/congregation? *
Where is your home church/congregation located? (City, State) *
What is the name of your pastor? *
What is the name of your current church/congregation? (if different from home church/congregation)
Where is your current church/congregation located? (City, State)
What is the name of your pastor?
Condition of health *
Do you have any medical conditions that we need to be aware of for housing purposes? If yes, please explain. *
Do you have any food allergies or dietary restrictions that we should be made aware of? *
How did you hear about Riverside? *
Check all that apply
Required
Education Level *
Required
What year did you graduate from high school? *
What is your current and/or past college experiences? *
(Indicate where you are currently attending school, if you are.)
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