First Presbyterian Church Meadville, Pennsylvania
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    Royal Family Kids Counselor/Staff Application 

    Instructions: Please fill out all the information on this form. The information is vital to your acceptance and possible placement as a counselor.
    (ALL information is held strictly confidential)


    What do you do for a living?
    How many years have you worked there?

    Provide an email address that you check often
    Be sure to provide the area code
    Be sure to provide the area code
    Be sure to provide the area code
    Provide an emergency contact
    Provide the relation of the emergency contact to you. (Mom, Dad, Aunt, etc..)

    Select one that best suits you
    Check all that apply
    (CAMP USE ONLY)


    Medical History

    If you have had training or background in dealing with abused, neglected, or abandoned children, please provide in what way
    If you have been abused, neglected, or abandoned and are willing to talk about it, please do so below.

    If you have any medical problems please list them here
    If you have a physical handicap or condition, please describe it

    Record of Education

    What high school did you attend?
    When did you graduate?
    If you went to college, put the college you attended below

    Personal References

    (not former employees or relatives)

    Personal Profile


    Applicant's Statement

    The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children or youth work. In consideration of the receipt and evaluation of this application by Our Father’s Children, Inc., I hereby release any individual, church, youth organization, charity, employer reference, or any other person or organization, including record custodians, both collectively and individually from any and all liability for damages of whatever kind of nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application.

    ​Further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act. This is a legally binding agreement which I have read and understand.

    Please be advised that a criminal history check will be requested from the state of PA and others applicable as authorized by state law.

    By signing my name, I hereby signify the above information is true and correct to the best of my knowledge
    (You will be required to sign this statement in person during training)
Submit
(814) 333-2161

​890 Liberty Street, Meadville PA, 16335
Picture
  • Home
  • Visit Us
  • History
  • Who's Who
  • News & Events
  • Music
  • Study & Service
  • Contact Us
  • More...
    • Lifetouch Directory
    • Presbyterian: What's That?
    • Officers
    • Presbyterian Women
    • Architecture
  • Photo Gallery