Volunteer with Us

One Step Closer to Volunteering!

Today's Date

Name*

Middle Name

Former Name(s) and Date Used

Spouse Name (If both of you are volunteering, each person must complete an application)

Primary Phone*( ) -

Other Phone( ) -

Email*

Best way to contact you*

Which type of volunteer are you?*

Event Based (one time basis)

Seasonal

Long-Term

Please list or describe the type of work you are interested in.*

Current Occupation*

How long have you been associated with our camp?*

Beginning of Availability*

End of Availability*

Details of Availability*

Please write a short paragraph telling how you became a Christian:*

Current Address*

How long have you live at this address?*

Previous Address*

How long did you live at this previous address?*

Social Security #*

Date of Birth*

Driver's License Number and State*

Date License/I.D. Expires*

Confidential Background Check Authorization and Screening

I hereby authorize Indian Hills Camp and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit reports, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records.

I further authorize any individual, company, firm, corporation, or public agency (including Social Security Administration and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me, to Indian Hills Camp or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation or public agency may have, to include information or data received from other sources.

I hereby release Indian Hills Camp, the Social Security Administration, and its agents, officials, representative or assigned agencies, including officers, employees, or related personnel both individually and collectively, from any and all liability for damages of whatever kind, which may, at any time, result to me, my heirs, family, or associates because of compliance with this authorization and request of release.

FOR THOSE WORKING WITH OR IN THE VICINITY OF CHILDREN OR YOUTH

This screening form is to be completed for any Shiloah Bible Retreat, Inc. position (volunteer or compensated) involving the supervision or care of preschoolers, children and/or youth. This is not an employee application form. This form is used to help the Shiloah Springs Bible Retreat, Inc d.b.a. Indian Hills Camp provide a safe and secure environment for those children and youth who participate in our programs and use our facilities. Individuals considered for a position in the preschool, children and youth ministry reas must be members of Shiloah Springs Bible Retreat,Inc. d.b.a. Indian Hills Camp.

I have read and agree to abide by Shiloah Springs Bible Retreat, Inc.'s policies and materials presented as part of this opportunity to serve. I further agree to submit to Shiloah Springs Bible Retreat, Inc leadership as it relates to my serving.*

Yes

Is person completing this form is a minor? If so their parent or guardian must sign below in addition to the minor.*

Yes

I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENT THEREOF, AND I SIGN THIS RELEASE BY TYPING IN MY NAME BELOW AS MY OWN FREE ACT. This is a legally binding agreement which I have read and understand. *

Parent / Guardian Signature

Please leave this field blank.