Camp Manitoumi Volunteer Counselor Application

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The information below is needed to help the camp provide a safe environment for the young people that attend camp. The information will be kept confidential and only shared if needed in ministry or as required by law.

If you have any questions, please email us at manitoumi@mtco.com or call at (309) 367-4651

Name *

First and last name

Email *

Phone number *

Home Address (Street, City, State, Zip) *

Birthdate *

YYYY

Sex *

Male

Female

Which week(s) do you plan to counsel? *

Beginner

Junior 1

Junior High

Senior High

Junior 2

Required

Church you attend (Name, City, State) *

Pastor's Name *

Are you a member of this church *

Yes

How often do you attend church *

Every Week

Every other week

Once a month

Less than once a month

What ministries are you involved in and what talents do you have? *

Give a brief testimony of how you came to Christ and your baptism by immersion. *

Do you? *

Use tobacco in any form

Use recreational drugs

Use non-prescription drugs

View pornographic material

None of the Above

Required

Have you ever been convicted of a felony? *

Yes

Have you ever been accused, charged, or alleged to have committed any act of neglect, abuse, or molestation of any child? *

Yes

If yes, to the above question, please explain.

Do you have any physical or mental impairments or spiritual weakness that might limit or resist your ability to serve as a counselor?

Do we have permission to do a background check? *

Yes

Please read our Camp Doctrinal Statement. Please type your name if your beliefs are in agreement with the Doctrinal Statement of Camp Manitoumi. *

Are you in agreement with the following statement:

“I Consider counseling a ministry unto the Lord and will cooperate with the Dean of the week and abide by ALL camp guidelines. Should at any time I find that I cannot in good conscience work with the Dean or within the camp guidelines I will immediately talk with the Dean and Camp Director and, if unable to resolve the problem, I WILL IMMEDIATELY RESIGN AS A COUNSELOR.”

Yes

Clear selection

Pastoral Reference: Please provide contact information (name, email, phone number) for your pastor (no other reference will be accepted). If you are a pastor, please provide the name and contact information for another pastor on staff with you or one of your deacons/elders.

We will then send a link for them to fill out a reference form. It would be good for you to contact them and notify them that a reference form will be coming. Your application will not be processed until we receive the reference form back.

Submit

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