New Staff Application

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New Staff Application

Dear applicant,
1. Fill out completely
2. We will contact you for an interview
3. If you have any questions, feel free to give us a call or send us an email.

Personal Information

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Upload Recent Picture *

Max file size: 20MB

Phone Number *

Email *

Social Security Number *

Parent's Name *

Parent's Phone Number *

Sex *

Age *

Birthday *

School You Attend *

Grade *

Health Information

Tetanus (Booster Recommended every 10 years after initial immunization) *

Polio (1963 oral series sufficient or at least 4 by kindergarten) *

Is applicant subject to: *

Diabetes Nosebleed Earache Headache Frequent Colds

continued *

Abscessed Ears Stomach Upsets Sleepwalking Asthma

continued *

Fainting Sore Throat Sinusitis Bronchitis

Serious Allergy *

Bee Sting Poison Ivy/Oak/Sumac Other

Please List all Know Allergies *

Please List Any Medications to be Taken (This must be administered by the camp nurse while at Camp.) *

Please: 1. Explain any health problems (physical or psychological). 2. Fully explain any other important health related information. 3. List any activity restrictions *

Emergency Contact *

First

Last

Emergency Contact's Address *

Line 1

Line 2

City

State

Zip Code

Country

Emergency Contact's Phone Number *

Submit

865-453-6274 | [email protected] | 2320 Happy Hollow Road, Sevierville, TN 37862

Home
Summer Program
Staff Opportunities
- Summer Staff
- Gap Year Program
Group Retreats
Serve with Purpose
Connect
- Contact
- Newsletter
About