twin ponds camp / camp starrigan leadersintraining … · 2. profanity, off colour language or...
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TheSalvationArmyNLDivisionalHeadquartersYOUTHDEPARTMENT
NLCAMPINGMINISTRIES
TWINPONDSCAMP/CAMPSTARRIGANLEADERSINTRAINING(L.I.T)ApplicationDeadline:April29,2011
DearApplicant:
WearesopleasedthatyouhaveaninterestinbecomingapartoftheLeaders‐In‐TrainingProgrambeingofferedatTwinPondsCampandCampStarrigan.
LeadersInTrainingisatwoweek,onsiteprogram,assistingyouthinthedevelopmentofspirituallifeandleadershipskillsintheCampsetting.
Theprograminvolvescounsellorshadowing,programparticipation,aswellasspecifictrainingsessions.Individualswillassistwiththeleadershipofvariouscomponentsofthecampprogram(recreation,electives,Bible,eveningprograms,campfire,etc...)LIT'swillalsoattendStaffDevotionsasassigned.Togainagreaterappreciationofwhatthetotalcampingministryinvolves,theLeaders‐In‐TrainingProgramwillinclude"ServiceDays."ThiswillgiveopportunitiestoprovidehandsonserviceintheKitchen,DiningRoom,orMaintenanceareasofcamp,asdecidedbytheCampDirector.AsaparticipantintheLITProgramitwillbeimportanttodisplaycooperation,flexibilityandenthusiasmforallareasofCampLife!
TheultimategoaloftheLeaders‐In‐TraininginitiativeisthatthedevelopmentofanLIT'sspirituallifeandleadershipskillswillresultinpersonalgrowth,preparationforfuturecampstaff,aswellasongoinginvolvementatthelocalchurchlevel.
Ifyouareinterestedinbeingapartofthisprogram,pleasetaketimetoreadthroughtheinformationprovidedandcompleteALLsectionsoftheapplication.
PleasetakenotethatapplicationsaredueatNLDivisionalHeadquartersonApril29,2011.
Ifyouhaveanyquestionsasyouworkthroughtheapplicationprocess,pleasedonothesitatetocontactusat:
or
Welookforwardtoreceivingyourapplicationandthepossibilityofsharinginministrywithyouthissummer!
Blessings
JuliaButler(Captain)DivisionalYouthSecretary
CampStarrigan
Camp#1 July11‐15
Camp#2 July18‐22
Camp#3(TeenCamp)
August15‐19
TwinPondsCamp
Camp#1 July11‐15
Camp#2 July18‐22
Camp#3 July25‐29
Camp#4(TeenCamp)
August1‐5
PleaseSelectOneorTwoweeks
Wouldyoubewillingtochangeadate? Yes No
LastName: FirstName: Male Female
HomeAddress City/Town
Province PostalCode Email:
BirthdateMM/DD/YYYY Telephone:
MCP#(Optional)P
ersonalInform
ation
__________________________________________________________________________________________Parent/GuardianSignature:Date
Thereisa$120RegistrationFeefor2weeksofCamps
Thereisa$60RegistrationFeefor1weekofCamp
TheLeadersInTrainingprogramisgearedtowardyoungpeoplewhohaveadesiretoshareChristthoughtheiractions,andattitudes.Theygainvaluableleadershipskillsthatwillequipthemforpotentialemploymentopportunitiesinthefuture.TheSalvationArmyCampingMinistryoffersthisprogramatCampStarriganandTwinPonds.
PersonalIdentification–AllApplicantsMustbeatLeast14YearsofAge
The Salvation Army Camp Ministry NL Division Leaders In Training 2011 Application Form
CodeofConductforSalvationArmyLIT’s
1.Inter‐PersonalRelationships‐Fraternizationbetweenbothstaffmembers(LIT’s),willbecontrolledandadherencetocamppolicyisrequired.
• Nomalestaffmemberareallowedinthefemalestaffquartersatanytimeandviceversa• Nomalestaffmembersareallowedinthefemalecampcabinsandviceversa• Campstaffvisitorswillconformtocamppolicy.
2.Profanity,offcolourlanguageorgraffitiofasuggestivenaturewillnotbetolerated
3.DressCode‐Inappropriateorrevealingclothing(suchasshort‐shorts,bellytops,strapless&lowcutshirts,spaghettistraps,andSpeedo’s)arenottoleratedonCampgrounds.
4.Smoking,Drinking,Drugs‐InkeepingwithSalvationArmystandardsandprincipals,smoking,drinking,ofalcoholicbeverages,ordrugusewillnotbepermittedoncampgrounds.Contraventionofthisrulebyanystaffpersonwillresultinimmediatedismissal.
5.Gamblinginanyformwillnotbetolerated
6.Staffdevotionswillbeheldatadesignatedtimeandit’sexpectedthatallLIT’swillbepresentaspartoftheprogram.
7.Allstaff,suitablyattired,unlessondutywillattendSundayworshipservicesasarranged.
Ihavereadtheabove‐mentionedCodeofConductfortheSalvationArmyLIT’sandagreetoabidebyitscontentsifIamacceptedintheLeadershipInTrainingProgramatCampStarriganorTwinPondsCamp.
IunderstandthatenteringtheLeadershipinTrainingProgrammeansacceptingtheresponsibility,alongwiththeCampingStaff,ofparticipatingatcampactivities.MygoalistoministertothechildrenthatattendcampandthatIwillpositivelyimpacttheirlivesthroughmybeliefs,actionsandattitude.
__________________________________________________ _______________________________________ SignatureofApplicant Date __________________________________________________ ________________________________________ SignatureofGuardian/Parent Date
AndrewWhite(B.Rec)(B.B.A)CampDirectorTheSalvationArmyNewfoundlandandLabradorDivision
21Adam’sAvenueSt.John’s,NLA1C4Z1
Telephone:(709)579‐2022Fax:(709)576‐7034
Email:[email protected]
SpiritualMaturityPleaseAnswerthefollowingquestions:
1.GiveabrieftestimonyastoyourChristianExperience.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2.HowwouldyouexplainthewayofSalvationtoacamper?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3.Howwouldyoudescribeyourrelationshipwithyourparentsandotherfamilymembers?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4.WhydoyouwishtoparticipateintheLeadershipTrainingProgram?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
The Salvation Army Camp Ministry NL Division
Leadership In Training 2011 Medical Form LastName: FirstName: Male Female
HomeAddress: City/Town:
Province: PostalCode: Email:
MCP#(Optional)
PersonalInform
ation
BirthdateMM/DD/YYYY: Telephone:
Primary:
Name:
Secondary
Name:
HomePhone#
HomePhone#
Contact
Inform
ation
Work/CellPhone# Work/CellPhone#
Allergicto:PleaseSpecify Reaction(PleaseSpecify)
Severity(Mild,Medium,Severe)
Treatment/MedicationRequired
Medication:(Penicillin,Sulfa,Cephalosporin,Anesthetic,etc)
Foods:(EggsFish,Nuts,Fooddye,Gluten,etc)
Insects:(Beestings,Waspflybites)
Environmental:(Pollen,hay,dust)
Allergies&DietaryConsiderations
DietaryNeeds:(Diabetic,Vegetarian,LactoseIntolerant)
Consent
Tothebestofmyknowledgetheaboveapplicantisingoodhealthandabletoparticipateinallcampactivities.Shoulditbenecessary,IherebygivepermissionformychildtoreceivemedicaltreatmentiffeltnecessarybytheCampDirectorandexaminingphysician.
_____________________________________________________ ________________________________________SignatureofParent/Guaridan Date
THE SALVATION ARMY
CANADA & BERMUDA TERRITORY
STATEMENT OF APPLICANT FOR WORK WITH CHILDREN
It is essential that The Salvation Army provide a safe and secure environment for children who participate in its programs and who use its facilities. To help achieve this objective, this statement will be completed by:
(a) Candidates for Officership, Auxiliary Captains and Envoys (b) Applicants for employment and volunteer positions in The Salvation Army (including Local Officers) which involve ongoing contact with children; and
(c) Applicants for employment and volunteer positions who may, by virtue of their job responsibilities, be in proximity to children in Salvation Army
Personal Information
Name
Last First Middle
Present Address
No. Street City Prov. Postal Code
Telephone Number : Home ( ) Work ( ) _____________
Training For Work With Children
List formal education and on-the-job training. Briefly describe the extent and nature of this education/training and identify the institution which provided this education/training. Those in category (c), described above, are not required to answer this question. If you are in category (c), please mark an "x" here ____________ and proceed to the questions on the next page.
Prior Work With Children
List all positions which you have held as a volunteer or an employee, that involved working with children. Provide the name of each organization, indicate the approximate dates during which you held each position, and identify your reason for leaving each position.
Criminal Record
Have you ever been convicted of an offense which involved the abuse or endangerment of a child? [You may answer 'No' if you were convicted of an offense for which a pardon was granted under the Criminal Records Act (Canada).] Yes No
'If yes, provide details of all such convictions:
Authorization
1. I hereby authorize The Salvation Army to conduct whatever searches it deems necessary, including a Police Records Search, to confirm that the information set out above is accurate and complete.
2. I hereby authorize The Salvation Army to conduct a search of all Child Abuse Registries maintained in Canada to confirm that I am not listed as a child abuser.
3. I hereby agree that, immediately upon request, I shall provide The Salvation Army with whatever consents and authorizations it requires to conduct the searches which are contemplated in paragraphs 1 and 2 above.
4. I hereby authorize any individual or organization, including any organization which maintains a Child Abuse Registry, and their agents, employees and representatives, to provide The Salvation Army with any information which they have regarding my character and fitness for work with children. I hereby release all such organizations and individuals from all claims, demands, actions and causes of action whatsoever, which may in anyway arise out of the provision of such information to The Salvation Army.
Signature of Witness Applicant
Name (please print) Date
Date
Royal Gendarmerie Canadian royale Mounted du Police Canada
APPLICATION FOR CERTIFICATE OF CONDUCT
NOTICE: A person requiring a Certificate of Conduct must complete the following steps:
I. Complete this Form (Including Section 2, if applicable) and take the Form to the Provincial Court office having jurisdiction for
the area of your residence. Obtain a Court Record Check. You may be charged a processing fee for this Check.
The Court Record Check fee may be waived by the Provincial Court in certain circumstances. Fees have been waived for
persons applying to adopt a child through the Department of Human Resources and Employment and for persons applying for
volunteer positions with certain volunteer agencies. This waiving of fee requires completion of Section 2 of the Form.
II.Bring the completed form and the Court Record Check form to the appropriate RCMP Detachment. The Detachment will
require a minimum of forty-eight (48) hours (excluding weekends) to process this application. The Completed Certificate will
only be provided to the person named. Suitable identification will be required.
SECTION 1: (To be completed by all applicants) Please Print:
SURNAME: MAIDEN NAME:
GIVEN NAMES: First Second Third
DATE OF BIRTH: PLACE OF BIRTH: Year Month Day
PRESENT ADDRESS:
MAILING ADDRESS (including postal code):
LIST ALL PREVIOUS ADDRESSES (IF DIFFERENT FROM ABOVE):
1) FROM: TO:
2) FROM: TO:
3) FROM: TO:
HOME PHONE NUMBER WORK PHONE NUMBER
IF YOU ANSWER YES TO ANY OF THE FOLLOWING QUESTIONS, PLEASE ATTACH DETAILS.
1. Have you ever been convicted of any offence in Canada or the United States, for which a pardon has not been granted?
YES NO
2. Have you ever changed your name? YES NO
3. Have you ever been prohibited by any court from possessing any firearm, ammunition or explosive substance? YES NO
WHY ARE YOU APPLYING FOR A CERTIFICATE OF CONDUCT? __________
CONSENT AND WAIVER:
a) I hereby request that a search be conducted of the records of the Royal Canadian Mounted Police to determine if there are any criminal convictions or criminal findings of guilt related to myself in these records. I hereby consent to the disclosure of any and all information resulting for this check.
b) I hereby agree that no liability attaches to the Royal Canadian Mounted Police in relation to this record search. I further agree that the Royal Canadian Mounted Police is not responsible for any inaccuracies that may result from this search.
APPLICANT'S SIGNATURE: DATE:
SECTION 2: (VOLUNTEERS AND PERSONS WORKING WITH CHILDREN)
This Section is to be completed by those applying to work or volunteer with agencies or groups dealing with children or young persons (under 18 years), elderly, individuals with special physically or mental health needs.
Name of Agency or Group:
Contact Person: Telephone No.:
Position applying for:
In making this application for a Police Conduct Certificate under this Section, I agree to allow the Royal Canadian Mounted Police to:
a) extend the search to include current investigations and present and pending charges:
b) notify the institution or agency of any ineligibility to obtain a Police Clearance Certificate, and
c) notify the agency or group representative of any present or pending charges against me:
APPLICANT'S SIGNATURE: DATE:
SIGNATURE OF AGENCY REPRESENTATIVE:
CONSENT FOR A CRIMINAL RECORD CHECK FOR A SEXUAL OFFENCE FOR WHICH A PARDON HAS BEEN GRANTED OR ISSUED:
(NOTE. This section Is to be completed by a person applying for a position with a person or organization responsible for the well-being of one or more children or vulnerable person, 1/ the position Is a position of authority or trust relative to those children or vulnerable persons and the applicant wishes to consent to a search being made In criminal conviction records to determine If the applicant has been convicted of a sexual offence listed In the schedule to the Criminal Records Act and has been pardoned.)
CONSENT
I consent to a search being made in the automated criminal records retrieval system maintained by the Royal Canadian Mounted Police to find out if I have been convicted of, and been granted a pardon for, any of the sexual offences that are listed in the schedule to the Criminal Records Act.
I understand that, as a result of giving this consent, if I am suspected of being the person named in a criminal record for one of the sexual offences listed in the schedule to the Criminal Records Act in respect of which a pardon was granted or issued, that record may be provided by the Commissioner of the Royal Canadian Mounted Police to the Solicitor General of Canada, who may then disclose all or part of the information contained in that record to a police force or other authorized body. That police force or authorized body will then disclose that information to me. If I further consent in writing to disclosure of that information to the person or organization referred to above that requested the verification, that information will be disclosed to that person or organization.
APPLICANT'S SIGNATURE DATE:
OFFICE USE ONLY
COURT CHECK: CPIC CHECK: PIRS CHECK: OTHER CHECKS:
CERTIFICATE COMPLETED: LETTER SENT: AGENCY ADVISED:
SIGNATURE OF PERSON COMPLETING CHECK: DATE:
References
Pleasegivecontactinformationtoapersonwhowillbeabletogiveanaccuratecharacterprofileofyou.Donotusefamilymembersorrelativesasareference.
Youmayusesomeoneovertheageof19whoknowsyouwell.
Name: Telephone:
Address: City/Town: PostalCode:
Email: Occupation:
Note:Pleasefindenclosed,referenceforms,whichyouwillneedtohavetheabovepersonscompleteandreturnDIRECTLYTOOUROFFICE.
Thesearenottobereturnedtotheapplicant.
Icertifythatanswersgivenaretrueandcompletetothebestofmyknowledge.Iunderstandthatanydiscrepancieswillresultinmydismissal.Iunderstandthatfalseormisleadinginformationgiveninmyapplicationmayresultindischarge.Iunderstand,also,thatIamrequiredtoabidebyallrulesandregulationsoftheemployer.
____________________________________________________________________________________________________Signature Date
AndrewWhite(B.Rec)(B.B.A)CampDirectorTheSalvationArmyNewfoundlandandLabradorDivision
21Adam’sAvenueSt.John’s,NLA1C4Z1
Telephone:(709)579‐2022Fax:(709)576‐7034
Email:[email protected]
The Salvation Army- Newfoundland Division Camp Starrigan/Twin Ponds Camp
Reference Form
SPIRITUALQUALITIES
a)Doestheapplicantmakeaprofessionoffaith?Yes No
b)Ishis/herlifeconsistentwiththeprofessionYes No
c)Doestheapplicantattendchurchfunctionsregularly?Yes No
d)Willtheapplicantmakeavaluablecontribution?Yes No e)Doestheapplicantparticipateinanychurchprograms?Ifso,inwhatcapacity?_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
NameofApplicant______________________________________________________________________________________________Howlonghaveyouknowntheapplicant?____________________________________________________________________Howwelldoyouknowtheapplicant?________________________________________________________________________Pleasecommentofthefollowing
Name:_________________________________________________Occupation:______________________________________________Address__________________________________________City:___________________________________Province:____________PostalCode:__________________Telephone:Home______________________________Work___________________________Email:______________________________________________________________________________________________Signature:________________________________________________Date:__________________________________________
1.Doyouknowofanyreasonwhythispersonwouldnotbeaneffectivecampmember? Yes NoPleaseComment____________________________________________________________________________________________________________________________________________________________________________________________________________________2.Istheapplicantthekindofpersonwithwhomyouwouldentrustyourchildren? Yes NoPleaseComment________________________________________________________________________________________________________________________________________________________________________________________________________________________3.Isthereanyfurtherinformationthatwouldassistusintheconsiderationofthisapplicant?
Yes NoPleaseComment______________________________________________________________________________________________________________________________________________________________________________________________
AboveAverage Average Fair PoorLeadershipAbility Abilitytoassumeresponsibility Abilitytogetalongwithothers WillingnesstoCooperate Abilitytoworkwithchildren Capacityfordevelopment
Thank you for your assistance in completing this form. Please Mail completed forms, under Private & Confidential cover directly to:
The Salvation Army- Newfoundland Division Camp Starrigan/ Twin Ponds Camp
Reference Form (Continued)
Pleasecheckthestatements,whichyouthink,applytotheapplicant.Thisevaluationwillallowstoexaminetheirattitudes,habits,andareasthatmayneedwork.Feelfreetoaddanystatementiftheoneslisteddonotadequatelydescribetheapplicant.
WorkHabits
EnjoysWork Procrastinates Reliesonothers Completes
AssignmentsFollows
Instruction
Sloppy Timely Perfectionist IgnoresInstruction Punctual
Late QuitterOther:
LeadershipAbility
Follower GetsResults AcceptsResponsibility
Enjoystakingcharge
Uncomfortablewithleadershiprole
LeadershipcomesNaturally
Pacesetter:
Other
PleaseCommentontheapplicantChristiancommitment.DoyoufeelthattheapplicantiscapableoffulfillingaleadershiproleataChristianCamp?_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DoyouthinktheapplicantwouldbeagoodfitworkingataChristiancampthissummer?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
AndrewWhite(B.Rec)(B.B.A)CampDirectorTheSalvationArmyNewfoundlandandLabradorDivision
21Adam’sAvenueSt.John’s,NLA1C4Z1
Telephone:(709)579‐2022Fax:(709)576‐7034
Email:[email protected]