Are you available to work from TBA through TBA?
If not, please explain:
Past Employment Section
List your last 3 places of employment
In a paragraph or two, tell us why you want to work at Loucon.
Prospective employees will receive consideration without regard to race, sex, national origin, or disability.
Upon receipt of your application we will begin contacting your references. All applicants will be required to attend Loucon’s Interview Weekend, March 22-24, 2013, where you will be expected to lead devotions, Bible Studies, worship, games, and more. You will interact with past staff, applicants, full time staff, and committee members during the weekend. This will provide you with an opportunity to see if this is where God is leading you, and it will allow us to evaluate you on several levels. Loucon will communicate your assignments prior to the weekend so you may plan/prepare. If you are unable to attend the interview weekend you will have one other opportunity for an interview; however your attendance at our retreat will greatly increase your chances for a position. There will be a make up day for interviews should the weather prevent our event or there be another need. There will be only one make up date. Loucon will notify you of our decision in writing no later than April 10th.
Loucon Training & Retreat Center
Voluntary Discolsure Statement
Previous residence(s) for the past 5 years (include college & home residence)
Add Another Residence
Have you ever been convicted of any crime of violence against a minor, including but not limited to those
- Indecent assault and battery on a child under fourteen
- Indecent assault and battery on a mentally retarded person
- Indecent assault and battery on a person who has obtained the age of fourteen
- Rape of a child under sixteen with force
- Assault with the intent to commit rape
- Kidnapping of a child under sixteen with intent to commit rape
- Distribution and trafficking of narcotics or other controlled substance
- Intent to commit any of the above crimes
Have you ever been adjudged liable for civil penalties or damages involving sexual or physical abuse of
Are you subject to any court order involving sexual or physical abuse of a minor including, but not limited to
a domestic order or protection?
Have your parental rights ever been terminated for reasons involving sexual or physical abuse of children?
I understand that the camp may deny employment to any persons who answers any of the questions above in
the affirmative &/or in applying for a counseling position the information which I have furnished on this form is subject to
verification, which may include a criminal history check and request from any Central Registry of child abusers. And/or the camp may
terminate employment or volunteer service of any person:
- Found to have a history of complaints of abuse of a minor and/or
- Found to have resigned, been terminated, or been asked to resign from a position whether paid or unpaid, due to complaint(s) of sexual abuse of a minor. This disclosure statement must be updated yearly
Loucon Authorization and Request
for Criminal Records Check
I, [APPLICANT], hereby authorize Loucon Training & Retreat Center to request the police
department, Sheriff's department, and/or the F.B.I. to release information regarding any record of charges or
convictions contained in its files, or in any criminal file maintained on me, whether said crimes committed
against minors, to the fullest extent permitted by state and federal law. I do release said police/sheriff/F.B.I.
from all liability that may result from any such disclosure made in response to this request.
Print all other names that have been used by the applicant (if any):
Place of Birth:
Social Security Number:
Applicant Release and Waiver of Rights
I, [APPLICANT], hereby certify that the information I have provided on this application for
employment is true and correct. I authorize Loucon Training & Retreat Center to verify the information I have
provided in the application, voluntary disclosure statement, and/or authorization and request for criminal
records check by contacting the references I have listed, by conducting a criminal records check, or by other
means, including contacting others whom I have not listed. I authorize the references listed in this application to
give you whatever information they may have regarding my character and fitness for the employment position
for which I have applied. Furthermore, I waive any rights I may have to confidentiality.
In the event that my application is accepted and I become an employee at Loucon Training & Retreat Center, I
agree to abide by and be bound by the policies of Loucon and to refrain from inappropriate conduct in the
performance of my duties on behalf of Loucon.
I have read this waiver and the entire application, and I am fully aware of its contents. I submit this consent freely
and under no duress or coercion.
- All summer staff shall be committed Christians and exhibit Christ-like conduct at work and at play. Summer staff is encouraged to approach his/her time at Loucon not only as a job, but also as an opportunity to be in service for our Lord. Staff is also encouraged to use their summer as a time of personal growth. Resources, possible study, and worship times will be made available upon request. Devotional service will be conducted daily for staff participation.
- Each staff member will receive a job description outlining his or her primary and secondary duties. The Directors will make staff assignments. Such assignments may include being called to carry out “all camp duties”. For efficient operation of the camp, punctuality and regular attendance of the staff is necessary and required. Summer staff is expected to support one another in their work, help out as the need arises, and recognize that we are working as a team toward a common goal.
- Summer staff will arrive for work on Sundays at 1:30 p.m. CDT. All are expected to remain on campus for the duration of the week. Town runs may be scheduled on Tuesday and Wednesday nights for the staff to eat dinner and have personal time. All staff is expected to attend morning meetings, which will be held at 8:00 a.m. each day. The workweek ends on Friday when the entire camp is clean.
- Summer staff shall interact in a positive manner with campers. They shall be involved in evening activities such as folkdancing and worship as long as it does not interfere with the individual’s schedule. No more than three staff members should sit at a table during meal times with the exception of breakfast.
- Any form of physical or mental abuse towards campers, deans, counselors, or other staff is forbidden. Question of sexual abuse shall result in the immediate notification of the authorities. Any such offence is ground for dismissal.
- Never be alone with a camper.
- Male and female staff is not to enter one another’s living quarters at any time. On the weekends, Short Cottage may be used for the male and female staff to gather. The bedrooms are off limits. The cottage must be completely clean by 1:30 p.m. on Sundays.
- Summer staff members are not to enter a dating relationship with campers or camp counselors. They are discourage from entering a dating relationship with one another, but if one is established, those involved are to conduct themselves in a manner that does not draw attention to their relationship
- The use of tobacco products is prohibited.
- Alcohol and/or illegal drugs are prohibited on Loucon property. Staff shall not return to the property under the influence of alcohol and/or illegal drugs. Such actions are grounds for dismissal. Staff are strongly encouraged to avoid the use of any such vice during their employment at Loucon.
- Summer staff should monitor their own sleep needs. If sleep deprivation becomes a problem, a lights out policy will be enforced.
- Summer staff is not to, under any circumstances, accepts tips or presents directly from campers or the camper’s parents.
- Summer staff shall abide by the camp curfew. Each staff member will be required to be in his or her respective housing before 12:00 midnight. Before midnight staff members are expected to travel in groups of three or more in order to protect both staff members and the campers. Additional Policies
- Summer staff is expected to discipline themselves in personal health in order to be at their best for camp and the campers.
- Loucon does not except responsibility for the loss or theft of staff member’s personal property.
- Summer staff will receive a $5 money card each week for purchases at the canteen.
- Staff visitors are to be cleared through the camp directors prior to the visitor’s arrival. Staff may entertain visitors on their authorized time off. Visitors may be asked to pay for their meal and are expected to adhere to the rules and regulations of Loucon.
- A washer and dryer unit is available at Turner for female staff use and Munday for male staff use.
- No pets.
- Telephone calls make during the day must be limited to 3 minutes. After 5:30 p.m., call may be made at the dining hall phone for an unlimited amount of time, but one must be courteous of others and only use line 2.
- Summer staff use of camp property such as craft materials, swimming facilities, sports equipment, etc. is permitted as long as such use does not interfere with ongoing camp programs.
- Loucon is not responsible for personal items used during the workday. (Vehicles, radios, CD’s, video and sound equipment, etc.)
Please write your name as an eletronic signature
I am over 18 years of age