Counselor Application RM_StatsPersonal InformationFirst Name *Last Name *Email *Address Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Zip Cell Number *Home NumberParent or Guardian Name *Parent or Guardian Phone *High School or College *High School Graduation Date *Have you ever been CRC staff? Yes No I can commit to the following camps: * Basketball Camp (June 8 & 9) Jr. High Day Camp (June 16-19) Elementary Day Camp (3rd & 4th grade: June 22, 24, 26, 30, July 2) Elementary Day Camp (5th & 6th grade: June 23, 25, 29 July 1, 3) Personal ReferencesWe require 2 Personal References. One reference is your pastor and the second is from your choice of the following categories: Employer, Teacher, and a Christian Worker.Pastoral ReferencePastor Name *Church *Phone Number *Email Address *Reference #2Name *Phone Number *Email Address * Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.