LDP 2 Application • Presbyterian Mo-Ranch Assembly

Applicant:*
First Last
Date of Application*
MM slash DD slash YYYY
Address:*
Street Address Address Line 2 City State ZIP Code
Phone:*
Email:*
Birthdate*
MM slash DD slash YYYY
LDP Session*
Select One
LDP I and II - Session 1: June 11-July 1 is full
- LDP I and II - Session 2: July 2-July 22

EDUCATION
School Attended*
Please list the school, city, state, major subjects, dates attended and degree.
Highest level completed by June 1, of this year?*
Honors received (academic or other)*

CHURCH AFFILIATION
Denomination*
Place of Worship*
City*
State*
Active Member?*
- Yes
- No
How long?*

ACTIVITIES
Name and brief description of School-Related, Church, and Community Activities*

PLEASE ANSWER THE FOLLOWING QUESTIONS
1. Why do you want to come back to be a LDPII at Mo-Ranch Summer Camps?*
2. What special contribution(s) can you make to the program?*
3. What did you learn from last summer? What do you want to learn from this summer?*
4. If you could teach one thing this summer, what would it be?*

SKILLS CHECKLIST
Please rate your degree of skill on the checklist below. Add comments or detail if you have particular skills in an area. Rank according to the following criteria:

1 = Experienced leading/teaching skill
2 = Experienced in skill
3 = Some experience in skill
4 = No experience in skill
Leadership
Activities
Bible Study*
Initiative Games*
Small Group Leader*
Low Ropes*
Worship Planning*
High Ropes*
Event Planning*
Rock Climbing*
Other
Other
Wilderness Skills
Aquatics
Camping*
Swimming*
LNT Ethics*
Canoeing*
Backcountry Cooking*
Kayaking*
Campfire Stories*
Fishing*
Fire Building*
Water Games*
Environmental Ed.*
Other
Other
Health & Safety
Arts
First Aid**
Drama*
CPR**
Dance*
Lifeguard**
Singing*
Instrument*
Photgraphy*
Other
Other
Sports
Crafts
Basketball*
Drawing*
Tennis*
Painting*
Baseball*
Pottery*
Softball*
Tie Dye*
Soccer*
Candle Making*
Disc Golf*
Leather Crafts*
Archery*
Nature Crafts*
Other
Other
Science
Languages
Insects*
Spanish*
Animals*
French*
Plants*
Other
Geology*
Miscellaneous
Astronomy*
Working with Children*
Meteorology*
Conflict Resolution*
Other
Other
Summer camp counselors are required to hold certifications in first aid, CPR and lifeguard. LDPs may receive these certifications additionally as part of their training.

REFERENCES & ACKNOWLEDGEMENTS
References
Three completed letters of recommendation must be returned directly to Mo-Ranch Summer Camps by February 1, of this year. Your references may include your pastor or youth minister, coach, teacher, or anyone of your choice (except a family member) who knows you and can assess your abilities. You may also request a letter from a previous staff member of your choice, if you have been a camper at Mo-Ranch in the past (or another camp that you enjoyed).
Applicant Certification*
I certify that all information given herein is true to the best of my knowledge. In the event of acceptance into the Leadership Development Program, I understand that false or misleading information given in my application or interview(s) may result in immediate dismissal. I also understand that I am required to abide by all policies, rules and regulations of Mo-Ranch Presbyterian Assembly and Mo-Ranch Summer Camps.
- I agree
Name (Applicant Signature)*

By typing your name, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.
Date*
MM slash DD slash YYYY
Parent/Guardian Acknowledgment*
Scroll and read entire acknowledgement
I, the parent/legal guardian of the applicant, understand and agree that:
1. My son/daughter has discussed with me his/her intent to apply for the Leadership Development Program (LDP) at Mo-Ranch Summer Camps, and
2. Permission is hereby granted for him/her to apply for the Leadership Development Program, and
3. Presbyterian Mo-Ranch Assembly may verify any information contained in this application. I release from liability any person giving or receiving any information requested by Mo-Ranch. I understand that unfavorable information or misrepresentation discovered as a result of this investigation my prevent my son/daughter from being accepted into the LDP program
4. I will encourage and support my son/daughter to participate fully in the Leadership Development Program, and
5. My son/daughter is – to the best of my knowledge – physically, mentally, spiritually, and socially able to fully participate in all aspects of the program.
6. I understand that space is limited in each session and my child may or may not be able to attend the session they desire. Final placement of LDP sessions will be determined by the camp director.
- I Agree
Parent/Guardian Name (Parent/Guardian Signature)*

By typing your name, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.
Date*
MM slash DD slash YYYY
Mo-Ranch Summer Camps provides campers the opportunity to grow in their faith by experiencing the love of God through relationships grounded in Christian faith, living in a community and playing and learning in our beautiful outdoor setting.
Untitled

Leadership Development Application II

EDUCATION

CHURCH AFFILIATION

ACTIVITIES

PLEASE ANSWER THE FOLLOWING QUESTIONS

SKILLS CHECKLIST

Leadership

Activities

Wilderness Skills

Aquatics

Health & Safety

Arts

Sports

Crafts

Science

Languages

Miscellaneous

REFERENCES & ACKNOWLEDGEMENTS

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