Application for Session Director at Wisconsin Christian Youth Camp 2012

Name ______________________________Phone___________________________ Age_______

address_________________________________________________________________________

state_____________  Zip_____________   email________________________________________

home congregation________________________________________________ years christian ______

current employer____________________________________________________________________

Check session you would prefer:  (dates subject to change)

____Middle camp ages 11-13  6/18 - 7/1                          ____Senior camp ages 15-18  7/16 - 29

____Intermediate camp ages 13-15  7/2 - 15                   ____Junior camp ages 9-11  7/30 - 8/12

____Quest retreat for all ages  dates TBA

Years worked at WCYC________ In what capacity_____________________________________________

__________________________________________________________________________________

Have you ever been convicted of a crime or charged with a sex crime?  Yes___  No___

Relevant training or camping experience:__________________________________________________

__________________________________________________________________________________

Share your philosophy of directing a camp session (use back if necessary)_______________________

__________________________________________________________________________________

References:

Name____________________________________phone________________email_________________

Name____________________________________phone________________email_________________

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mail to: Jim Coehoorn

           115 N. Broad Street

            Elkhorn, WI 53121                                  jimcoehoorn@yahoo.com