Mt. Lebanon -North Texas Retreat Center, Texas Christian Summer Camp

Name*
First Last
What do you prefer to be called?
Preferred Name
Date of Birth*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone*
Email*
Twitter
Instagram
How did you find out about Mt. Lebanon?

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Education
High School Attended
Year Graduated High School
College Attended
Number of Years Attended
Expected Graduation Year
Major Course of Study

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Experience
Have you ever attended or worked for a summer camp? If yes, which camp?
What were your job title and responsibilities?
Briefly describe any other ministry experience. Please include any volunteer experience which may be relevant.

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Certifications
Do you currently have... (Don't worry if you don't. It's just a point of reference for us.)
American Red Cross Lifeguard Training
- Yes
- No
Expiration Date
MM slash DD slash YYYY
Challenge/Ropes Course Training
- Yes
- No
Expiration Date
MM slash DD slash YYYY
Do you have any other training or certifications (please list expiration dates)?

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Employment Information

(begin with most recent)
Employer
Phone
Job Title
Employed from
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Supervisor
Responsibilities
Employer
Phone
Job Title
Employed from
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Supervisor
Responsibilities
Employer
Phone
Job Title
Employed from
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Supervisor
Responsibilities

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References

List the names, complete addresses, titles, phone numbers, and email addresses of three references, not related to you, who are willing to provide information about you. Appropriate persons would include pastors, employers, teachers, etc. Please do not list friends, roommates, or family members. This is a personal reference and we will be asking questions about your personality and spiritual maturity.
First Reference's Name*
Job Title
Relationship*
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email Address*
Second Reference's Name*
Job Title
Relationship*
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email Address*
Third Reference's Name*
Job Title
Relationship*
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email Address*

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Employment Dates
Our summer program runs for 9-10 weeks including orientation. This is typically the first week of June through the second week of August. If you are hired, will you be committed to work these dates?*
- Yes
- No
When does your school year end?
MM slash DD slash YYYY
What date you could start if hired?
MM slash DD slash YYYY
Our orientation will tentatively be from Monday, May 30th through Friday, June 3rd. Can you committ to these dates?*
- Yes
- No
Explain any commitments or plans that may conflict with our summer camping season if you are hired.

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Summer Staff Health Statement

Staff training requires participation in activities, which are physically challenging and will demand your complete attention and cooperation. These activities will physically and mentally challenge you and may cause elevated blood pressure, pulse rates, and respiration. It is imperative that you are free of any heart-related problems or other associated medical/ physical conditions, which might create undue risks to yourself or others that depend on you. You must be sure the activities do not exceed your ability. Good physical conditioning is essential and will increase your ability to perform safely and your enjoyment of outdoor activities. You will train and perform in a hot, dry outdoor environment and may experience prolonged sun exposure. If there is any doubt of your ability to safely participate in this training and other outdoor activities, you should consult a physician for a complete examination.
Applicant’s Statement

The information contained in this application is correct to the best of my knowledge. I hereby authorize Mt. Lebanon, and the Dallas Baptist Association, to thoroughly investigate my background & activities, references, employment record and other matters related to my suitability for employment. I authorize any reference, including my current employer (if applicable), previous employers, and organizations contacted by Mt. Lebanon to provide any relevant information, including opinions, which they have regarding my character and fitness to work at Mt. Lebanon, and I release all persons, organizations, and employers from any and all claims for providing such information.

I understand that misrepresentation or omission of facts may result in rejection of this application, or if hired, discipline up to and including dismissal. I understand that nothing contained in this application, or conveyed during any interview which may be granted, is intended to create an employment contract.

Your employment with Mt. Lebanon and Dallas Baptist Association is “at-will.” As an “at-will” employee, you may end your employment at any time, for any reason, with or without sufficient notice to Mt. Lebanon. Likewise, Mt. Lebanon may terminate your employment at any time, with or without sufficient notice, for any reason, with or without cause. Your employment relationship with Mt. Lebanon, and the Dallas Baptist Association, does not create an expressed or an implied employment contract.

I understand I will be required to complete an Employment Eligibility Verification Form (I-9), and provide the following documentation: (1) a state-issued driver’s license or state-issued ID, (2) original Social Security card. I will also be required to complete a Staff Health Statement, Staff Registration Form, and a Criminal Background/ Screening Form. Additionally, I understand that Mt. Lebanon reserves the right to request drug screening at its discretion for all employees at anytime.

I promise to abide by all Mt. Lebanon and Dallas Baptist Association policies and rules. I agree to cooperatively participate in all staff training and work. I will consistently maintain a Christian attitude and refrain from any conduct/actions which are inconsistent with an accepted Christian lifestyle or which would be unacceptable at a Christian camp.
Applicant’s Name (printed)*
Applicant’s Signature
Signature*
Parent/Guardian Signature (if minor)
Signature
Date*
MM slash DD slash YYYY
Questions or comments?

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Summer Staff Online Application

Summer Staff Application Form

Step 1 of 9 - Personal Info

Education

Experience

Certifications

Employment Information

References

Employment Dates

About Yourself

Summer Staff Health Statement

Applicant’s Statement

Contact Us

972.291.7156

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