APPALACHIAN OUTREACH
C-N BOX 71904
190 OLD W. ANDREW JOHNSON HIGHWAY
JEFFERSON CITY, TN 37760
865.475.5611
AOutreach@cn.edu

SUMMER STAFF APPLICATION
Note: All applicants must be high school graduates and must complete this form prior to interview.
This application form and six confidential reference forms must be completed.
 

GENERAL INFORMATION

Name:  Last   First   Middle   Preferred Name
Social Security Number   Age   Date of Birth (mmm-dd-yyyy)   MaleFemale
 

Current Mailing Address:
Street: 
City:      State:   Zip code:
Phone:  ()
E-mail Address:  		Permanent/Parent's Mailing Address (if different):
Street:  
City:       State:   Zip code:
Phone:  ()
E-mail Address: 

In case of emergency, please notify:
Name:  
Street:  
City:       State:   Zip code:    Phone:  ()

Have you discussed your desire to participate on AO Summer Staff with your parents?  Yes   No
If “yes” were they (select one): In Favor    Opposed    Neutral

EDUCATION
Name of School Currently Attending (Please do not use initials)

City:       State:   		Hours completed:    GPA:
Major:
Fresh    Soph    Junior    Senior    Grad
Other Schools Attended:

CHURCH INFORMATION
Present Church Membership:
Name of Church:
City:       State:  
Pastor's Name:
How long have you been a member?  years.
Do you attend church on a regular basis?  Yes   No
Have you served on a church staff?       Yes   No
If “yes” please list year, position, ages taught, supervisor:
Church Currently Attending (if different from membership):
Name of Church:
City:       State:  
Pastor's Name:
 
Are you currently involved in a campus ministry organization?
                         Yes   No
If “yes” please list year, position, ages taught, supervisor:

 

POSITION APPLYING FOR
Rank in order the position you are applying for – 1 being your first preference:

    Home Repair    Ministry Center     Samaritan House     Music/Worship Leader/BYBC
 

 

MISSION EXPERIENCE
Have you ever participated in a mission trip? Yes   No
If “yes” please list the year(s) and location(s) you participated:

List any other mission involvement, including year, location and sponsoring agency or church:

Briefly describe any other ways you have been involved in the lives of youth and/or ministry to youth:

 

WORK EXPERIENCE
Please list in reverse order the indicated information for any work or volunteer experience you have.
Use a separate line for each entry by pressing "Enter" after each line.
Company Name
or Organization
 Dates Employed
(month/year)
 Supervisor's
Name
Telephone

 		 Responsibilities (If any of these were as camp staff, indicate type of camp and location.)

 
 

List the general leadership experiences you have which you feel are valuable:

 

SKILLS
Please rate your experience in the following areas using the following key:
0-No experience 1-Beginner 2-Intermediate 3-Advanced
  Personal Management
  VBS Day Camps
  Instrumentalist
     Instrument:
  Photography
  Drama
  Counseling		   Journalism/Writing
  Language other than English
      Language:
  Leading Music 
  Singing (Solo)
  Camp Staffer
  Youth Ministry		   Office Management/Organization
  Sharing Testimony
  Preaching
  Driving 15-Passenger Van
  Evangelism
  Home Repair
  Public Speaking

 

PERSONAL SKETCH
Please type a brief personal sketch, as a guide to introduce yourself. Write in first person, essay form. Type as many lines and as many paragraphs as you need in the box provided. Press "Enter" only at the beginning of each paragraph:

1. How did you find out about Appalachian Outreach summer staff positions?

2. Why do you want to work as an AO staff member?

3. Why do you think you should be hired as an AO staff member?

4. What do you feel are your personal strengths?

5. Assess your ability to work as a cooperative team member.

6. What is your vocational call and how do you anticipate sharing your faith through your call?

7. State your concept of missions and your reason(s) for wanting to be a summer staffer with AO Ministries.

8. Will you commit yourself to daily prayer surrounding your decision to do missions at AO this summer?

9. Are you committed to a strong spiritual walk this summer to assist in daily preparation to accomplish God’s work?

10. Have you ever experimented with drugs and/or alcohol?
Discuss your own history, and your beliefs surrounding the use of these types of substances:

11. Are you prepared to work on a construction team for nine (9) weeks during the hot East Tennessee summer?
If no, explain:

 

PERSONAL CHARACTERISTICS
Check one or more of the characteristics you feel apply to you:
PHYSICAL HEALTH
Frequently incapacitated
Below average
Healthy
Extremely fit

EMOTIONAL
I feel I become stressed easily.
I usually feel little stress.
I handle stress well.

WHEN UNDER STRESS
I need to be alone.
I need to be with others.

PERSEVERANCE
I am easily discouraged.
I persist in most circumstances.
I persist under adversity.		 SELF-IMAGE
I often struggle with who I am.
I am comfortable with myself.
I feel good about myself.

ACHIEVEMENT
Do only what is assigned.
Easy to begin, hard to finish tasks.
Meet the expectations of me.

WORK HABITS
I can do my job even if no one notices.
I prefer to work alone.
I prefer to work with others.
I work with those of other temperament.
 		 SOCIAL
I get along well with a few.
I get along well with most.
I get along well with anyone.

LEADERSHIP
I follow leadership well.
I lead when the opportunity rises.
I prefer to lead.

TEACHABILITY
I am rigid in my opinions.
I am somewhat rigid in my opinions.
I am open-minded.
I am willing to receive instruction.
I am eager to receive instruction.

 

SPIRITUAL LIFE
Compose a brief essay that gives attention to the following issues:
  1. Briefly describe your initial encounter with Jesus Christ. How is Christ active in your life now?
  2. Give a brief statement of the basic Christian message that you hope to proclaim or share with persons you encounter in your ministry.
  3. Please share what you feel God is teaching you right now in your quiet time and personal study.

Type as many lines and as many paragraphs as you need in the box provided. Press "Enter" only at the beginning of each paragraph:

 

REFERENCES. 
     Please provide contact information on these six references, to whom you will give a reference form.
Reference's Name Street Address City St. Zip Phone
Pastor




Campus/Student Ministry




Sunday School Teacher




Employer/Work Supervisor




Personal Friend





Personal Friend





 

AVAILABILITY
Appalachian Outreach staff training may begin as early as May 20 with debriefing ending as late as August 5.
Please list the date you are available   through .
List any possible conflicts during the above dates .

 

STATEMENT OF PERSONAL CONDUCT
Please read carefully the paragraphs below before answering and signing.

Appalachian Outreach Ministries is committed to nurturing and ministering to young people and adults who attend projects with this relationship based on trust and respect. Therefore, A.O. staff must maintain conduct consistent with the purpose and mission of the A. O. Ministry. Are you presently involved in any lifestyle, conduct, or activity that would hinder your ministry with AO, or impede the program’s credibility with their constituents as mentioned above?   Yes No
If “yes”, please explain:

I understand that I will be under the guidelines and policies of the North American Mission Board and Appalachian Outreach Ministries.

I agree to abstain from the use of tobacco products, alcoholic beverages, illegal drugs, and any other behavior that would hinder my ministry during my term of service as a summer staffer.

I understand that use of these substances, or involvement in questionable conduct, will be cause for dismissal as a member of the Appalachian Outreach Ministry summer staff program.

In lieu of a signature, please type your full name: .  

When you click on the Submit button below, your responses to this form will be automatically sent to Appalachian Outreach. The date, time, computer identification and username will be transmitted with this form when it is submitted.   Please review your responses for accuracy before submitting this form.

                                      

After submitting the above form, a confirmation page will display all of your responses. That page may be printed or saved on your computer for your records. If you wish, you may drag your mouse over the lines of the above form, to select the entire form. Then you should be able to use the print function of your web browser to obtain a printed copy of this form and your responses. You should choose the "selected" portion of the printout, to avoid printing this entire web page. The printed copy may be used for your records or for sending the form by mail if you prefer not to use email.


CONFIDENTIAL REFERENCE FORM
 

The application for Summer Staff must be supported by six Confidential Reference Forms, to be filled out by the references you have listed in your application. These reference forms may be delivered by any of the following methods:

1. You may click on this link to the Confidential Reference Form, print copies of the form on your own printer and mail them to each person you have designated. You should include a stamped envelope addressed to

APPALACHIAN OUTREACH
C-N BOX 71904
190 OLD W. ANDREW JOHNSON HIGHWAY
JEFFERSON CITY, TN 37760.

If you prefer, you may click on this link to download the Confidential Reference Word Document. This will allow you to save the form as a Word document rather than a web page, for printing and mailing to your references.

2. You may email or otherwise communicate the following web address to each person who is providing a reference:
              Web.cn.edu/ao/ConfidentialReference.htm .
He or she may either fill out the form and submit it online or print it, to be mailed in. This person must have computer access to the internet.

3. Please note that it is your responsibility to deliver the Confidential Reference Form to each person providing a reference by whatever method you choose. The Reference Form should be sent directly to Appalachian Outreach rather than to you.
 

May God bless whatever ministry that you are able to perform in the coming months.