Summer Staff Application

Please note, our online form does NOT save, you must complete in one sitting. If you prefer, you may download our PDF application

Name *
Phone *
Date of Birth *
Date of Birth
Gender *
If different than your permanent address
Education & . Work Experience
List any previous work or volunteer experience (most recent first)
Have you ever been terminated or fired from a job? *
Have you ever been convicted of a felony, misdemeanor, or pleaded no contest in a felony? *
Have you ever been accused or convicted of physically or sexually molesting/abusing a person? *
Your application is incomplete without 2 reference forms; we ask that you have a reference form completed by a Pastor/Mentor and one by a Teacher/Employer/Coach and an Unrelated Adult. List the information below of those you gave the forms to:
Reference 1's Phone
Reference 1's Phone
Reference 2's Phone
Reference 2's Phone
Work Area of Interest
At PMBC we have three positions: counselor, program director and service team member. Counselors spend the majority of their day investing into the campers and are responsible for their supervision. The program director helps plan and implement the daily schedule of activities and programs. Our service team is comprised of everyone else. Our service team members must be willing to contribute in all areas of camp, such as cleaning, washing dishes, assisting counselors with campers, prepping meals, setting up games or even participating in skits. Our service team members will have an area of emphasis in which they will be held accountable. For instance, a housekeeping oriented service team member will be held accountable to keeping public areas clean, but will also assist in many other areas; or a kitchen-oriented service team member will mostly help within the kitchen but also be asked to help in other areas when needed. All PMBC summer staff members are expected to have a willing heart to serve and minister to campers and each other. Positions: Counselors, Program Director & Service Team Members Service Team Areas of Emphasis: Lifeguard, Kitchen, Housekeeping, Childcare, Rec Hall, Work Boy
Please list in order of preference which positions(s)/areas of interest you are applying for:
Earliest Date You're Available to Work This Summer
Earliest Date You're Available to Work This Summer
Latest Date You're Available to Work This Summer
Latest Date You're Available to Work This Summer
Licenses & Certifications
If you have any of the following certifications or licenses, please let us know by filling in when it expires
Include State and expiration
Expression of Faith
Pastor's Phone
Pastor's Phone
IF you have current clearances please indicate here: *