First Name:                  Last Name:    

 Home Address:  

City: State: Zip Code:

Home Phone #: - -   Email:

Date of Birth:               Age:                Male:         Female:  

 Name of Parents or Guardian:  

 Due to the nature of the summer conference ministry and in order to provide continuity, Summer Staff team   members are encouraged to stay the entire summer. First priority will be given to those individuals who can  commit to the entire summer. Exceptions may be made for conflicts with the ending or beginning of school.  Can you commit from the second weekend in June through Labor Day weekend?  Yes    No

 If "no" please specify "Start" and "End" dates and include reason.

 Start Date:                 End Date:  

 Reason:  

 Position Interested In:   Please rate 1-4 from most interested (#1) to least interested (#4)

                                    Food Service            Children's Ministry

                                    Snack Shop              Building & Grounds

                                    Audio/Visual             Lifeguard (Lifeguard Certification: Yes    No )

                                    Counselor                  *Staff Shirt Size:  Small   Med.   Lg.

 Church Background:

 What Church do you attend?

 Church Address:

 Are you a member?  Yes    No           How often do you attend?

 In what activities are involved in your church? 

 Name of Pastor:    Home Phone:

 Name of Youth Pastor:    Home Phone:

 Work Experience:

 Name and Address of your most recent employer:    Phone:

 Job Position:    From:    To:

 Have you ever worked at a conference center or camp?   Yes    No

 Where:    Contact Person:

 Phone:    How did you first hear about Pinebrook?

 If Pinebrook Staff experiece, how many summers served?

 Please list any other abilities, talents, certifications that may be useful at Pinebrook

 Do you play any musical instruments?  Yes    No        If so what?

 If applicable, would you be able to bring your instrument?   Yes    No

 Testimony:

 1. How does one become a Christian?

 2. Are you a born again Christian?  Yes    No    Briefly describe how you became a Christian.

 3. Describe your relationship with the Lord including some of the ways He has worked in your personal, social and spiritual life.

 4. What are you currently studying during your devotions?

 5. Describe your prayer life.

 6. What is your best quality? Describe how God has gifted you.

 7.  If you could change one thing about yourself what would it be?

 By checking this box I affirm that the content of this application is correct to the best of my knowledge.

 Pinebrook Bible Conference is a nonprofit Conference Center whose goal is to minister and to facilitate ministry. Our desire is that this facility be used to glorify our Lord and Savior Jesus Christ. Pinebrook is a ministry of the Bible Fellowship Church. NONDISCRIMINATION POLICY

 Pinebrook Bible Conference recruits and hires employees of any race, color, nationality, and ethnic origin. It does not discriminate on the basis of race, color, sex, national, or ethnic origin in administration of its policies  of employment, promotion, etc.