Application Let's get to know you! "*" indicates required fields Name* First Last Date of Birth MM slash DD slash YYYY Address* Street Address City State / Province / Region ZIP / Postal Code Phone*Email* What is your favorite thing about working with youth?*What are you applying for?* Adult Full-time Missionary Adult Half-time Missionary Adult Drop-in Volunteer High School Intern (11th or 12th grade only) What drop-in tasks are you interested in helping with?*Check all that apply. Lead a weekly program Supervise an intern-led program Chaperone campers at 12pm Mass Lead outdoor water games Chaperone and drive for field trips On which dates would you be able to help on field trips?*Check all that apply. Thursday, June 27 @ 12-5:30pm Friday, June 28 @ 12-5:30pm Thursday, July 11 @ 12-5:30pm Friday, July 12 @ 12-5:30pm Thursday, July 18 @ 12-5:30pm Friday, July 19 @ 12-5:30pm Thursday, July 25 @ 12-5:30pm Friday, July 26 @ 12-5:30pm Thursday, August 1 @ 12-5:30pm Thursday, August 2 @ 12-5:30pm Which weekly time slots would you be able to come?*Check all that apply. Monday Mornings (8:30am - 1:30pm) Monday Afternoons (12-5:30pm) Tuesday Mornings (8:30am - 1:30pm) Tuesday Afternoons (12-5:30pm) Wednesday Mornings (8:30am - 1:30pm) Wednesday Afternoons (12-5:30pm) Thursday Mornings (8:30am - 1:30pm) Thursday Afternoons (12-5:30pm) Friday Mornings (8:30am - 1:30pm) Friday Afternoons (12-5:30pm) Which weekly program slots would you be able to come?*Check all that apply. Monday Program 1 (9:30-10:30am) Monday Program 2 (10:40-11:40am) Monday Program 3 (1:40-2:40pm) Monday Program 4 (3:30-4:30pm) Tuesday Program 1 (9:30-10:30am) Tuesday Program 2 (10:40-11:40am) Tuesday Program 3 (1:40-2:40pm) Tuesday Program 4 (3:30-4:30pm) Wednesday Program 1 (9:30-10:30am) Wednesday Program 2 (10:40-11:40am) Wednesday Program 3 (1:40-2:40pm) Wednesday Program 4 (3:30-4:30pm) Thursday Program 1 (9:30-10:30am) Thursday Program 2 (10:40-11:40am) Thursday Program 3 (1:40-2:40pm) Thursday Program 4 (3:30-4:30pm) Friday Program 1 (9:30-10:30am) Friday Program 2 (10:40-11:40am) Friday Program 3 (1:40-2:40pm) Friday Program 4 (3:30-4:30pm) Select AllWhich days can you bring the campers to Mass?*We count on the chaperone to pick up the group of campers from Door 11 of the school building at 11:50am and return the campers after Mass. Check all that apply. Mondays Tuesdays Wednesday Thursdays What do you find most challenging about working with youth?*What is your preferred age group of youth to work with?* 1-2nd Graders 3-5th Graders Middle School High School Describe your hobbies and interests*What type of programs would you be interested in running?*Examples: music, sports, STEM, art, gardening, etc. Be as specific as you can!Write at least one lengthy paragraph telling us why you would like to volunteer at Camp Contigo and why you would make a good counselor. Be sure to comment on anything not covered already.*What are you looking to gain from this internship?*Educational Background*Please include your high school, colleges, grad schools, degrees, and certifications.Summer camp work involves close contact with children. Have you ever been investigated, arrested or convicted of Child Abuse, Neglect or Related Charges?* Yes No Have you already completed the VIRTUS training?*This training is required for all adults 18 years of age or older to volunteer with Contigo. Yes No For which diocese and parish did you complete the training?* Drug or Alcohol Charges?* Yes No Have you ever been convicted of any other criminal activity?* Yes No Do you have any physical limitations that would prevent you from performing the work for which you are being considered?* Yes No If yes to any of the above, please explain.*List 3 personal or professional references that can attest to your experiences working with youth, you faith life, and character.*Please include names, positions, and contact information.Is there anything else you think we should know?Let us know if you have scheduling conflicts or any special needs.Verification and Authorization* I certify that all information given on this application is true and I authorize investigation of all statements and information given in this application. I understand that misrepresentation or omissions of facts is cause for dismissal. I also authorize Contigo Inc. to secure an employment screening profile, including a criminal/background check and authorize the release of or securing of information for this purpose. Δ