Returning Staff Application

Name *

First

Last

Email *

Mailing Address (updated) *

City *

State *

Zip *

Phone Number *

Date of Birth (M/D/Y) *

T-Shirt Size *

Important note about position or availability *

Special Certifications? (Lifeguard, EMT...) *

Please update us on your current walk with the Lord *

How have you served and grown in the Lord this past year? *

How has the Lord been at work in your life in the past year? *

Since you last applied, have you been accused or convicted of any form of Child abuse? *

Since you last applied, have you been convicted of a crime? *

More information on legal matters *

Digital Signature : By typing your full name below you are indicating that the above information is true. *

Anything else that we should consider in your re-application *

Mailing address
PO Box 1214, Ellsworth, ME 04605
located in Charlotte Maine