International Program Application				Send check for $65 to: Signature Services Corp. 2705 Hawes Avenue Dallas, TX, U.S.A. 75235
PERSONAL INFORMATION  * - required
Surname*:			First Name*:
Street Address*:			City/Town*:
State*:			Country*:
Postcode*:			Phone*:
Email*:
Parents' Telephone:			Date of Birth (Mont/Day/Year):
Age*:			Birthplace*:
Gender:	Male  Female		Height:
Weight:			Passport No.
Driver's License:
Are you married?	Yes  No	If yes, is your husband or wife applying?		Yes  No
What is your earliest date of departure?*			Date due home*:
EDUCATION AND EMPLOYMENT INFORMATION
Are you currently a student?		Yes No	Course/Subject:
Are you employed full-tiime?		Yes No	Occupation:
Do you have experience on an international cultural exchange program?		Yes No	If yes, where and in what position?
Do you have previous experience with American summer camps?		Yes No	If yes, where and in what position?
CAMP TYPES
Will you work at a camp with religious emphasis?			Yes No
Do you have a personal religious commitment?			Yes No
Are you willing to participate in bible studies and devotions?			Yes No
Do you attend church services regularly?		Yes No	If yes, what church?
Do you have experience pioneering, scouting or guides?		Yes No	If yes, please describe below:
SKILLS – Please check skills as they apply:
	WILLING	EXPERIENCED		WILLING	EXPERIENCED
Cooking			Dishwashing
Dining Hall Service			Food Preparation
Dining Hall Manager			Assistant Cook
			Baking
Please fully describe your involvement with the skills you have detailed on this application. Describe your work experience - positions held, length of time, specific duties and responsibilities.
BACKGROUND
What qualities do you possess that will make you an excellent candidate for a position with Signature Services?			What experience do you have that demonstrates your ability to work long hours and to live in a community with strict rules (i.e. no smoking, no drinking)?
How well do you work as a member of a team? Give an example.
Give examples of your ability to adapt to new and different situations?			If English is not your first language, how confident are you in your ability to work effectively using the English language and why?
Have you ever been away from home for an extended peiod of time?		Yes No	If yes, please specifiy:
ADDITIONAL INFORMATION
Nondisclosure of any medical/criminal history will result in cancellation from the program and forfeiture of all payments made to Signature Services. All participants are required to be in good physical and mental health.
1. Do you smoke?				Yes No
2. Do you have any visible body tattoos and/or piercings?				Yes No
3. Do you have any dietary restrictions?				Yes No
4. Do you have any health problems?				Yes No
5. Are you presently on any medication?				Yes No
6. Do you have any allergies or require special medical treatment?				Yes No
7. Do you have any physical disabilities?				Yes No
8. Have you ever been a victim of sexual abuse?				Yes No
9. Have you ever been a victim of physical abuse?				Yes No
If you answered yes to questions 8 or 9, you must supply all details.
10. Have you ever suffered from a nervous breakdown, depression or mental disorder?				Yes No
11. Have you ever had an eating disorder (ex. anorexia)?				Yes No
As you will be working with children, we require that you give details of all convictions since the age of 16, including dates and judgements and any convictions that may normally be regarded as “spent”. These will be subject to official investigation. Persons with drug, violence, or child abuse convictions may not apply.
12. Have you ever been convicted for any offense or crime?				Yes No
13. Are you currently subject to a police investigation?				Yes No
14. Have you ever been charged with a criminal offense?				Yes No
If yes to any, please specify:
EMERGENCY DETAILS
Doctor's Name:			Doctor's Phone:
Emergency contact (friend or family) name:
Address:			Emergency Phone:
AGREEMENT
The facts set forth in my application for employment are true and complete. I understand that if employed, any false statements on this application may result in my dismissal. I further understand that this application is not and is not intended to be a contract of employment, nor does this application oblige the employer in any way if the employer decides to employ me. I also understand that I will have to adhere to camp policies and procedures such as curfew, no smoking, no drinking, and agree to abide by these policies.
I Agree, (name of applicant):
If you do not receive a response from us within 7 days, please call us at 1-800-929-5519 ext. 2045.