Education

Experience

Certifications

Employment Information

(begin with most recent)

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.

Employment Dates

About Yourself

Proof of citizenship or immigration will be required on employment.

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.

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.

Health Information

This health history is correct, and I believe that my health is satisfactory to participate in staff training and challenge course activities. I know of no physical limitations or disabilities, which could prevent me from safely completing staff training or participating in other camp activities without injury. I am aware of the inherent risks and difficulties associated with these activities and I represent that I am physically capable and will be properly dressed and equipped to participate safely in all activities. I understand that it is solely my responsibility to determine whether there is any medical reason that I should not participate in any staff training activities. My signature indicates that I have read and understand this health statement, and that I agree to its content.