CAIRN Application

Date of Birth *
Date of Birth
Permanent Address *
Permanent Address
Current Address
Current Address
(If Different)
Please mark your ability in each of these areas (1 being highest)
Please mark the following that you have current certifications in:
High School
Work History
Military Service
Reference 1
Reference 1 Name *
Reference 1 Name
Reference 1 Phone
Reference 1 Phone
Reference 2
Reference 2 Name *
Reference 2 Name
Reference 2 Phone
Reference 2 Phone
Reference 3
Reference 3 Name *
Reference 3 Name
Reference 3 Phone
Reference 3 Phone
(other than minor traffic violations)
Staff Agreement *
Realizing the great responsibility and opportunity of working with children at Camp Ao-Wa-Kiya, I agree to: Sacrifice personal desires in the interest of the campers; cooperate with the director and other leaders under whom I serve; obey camp and staff regulations printed in the staff manual; endeavor to be a blessing to the campers with whom I work by helping to enrich their lives spiritually, physically, and mentally; and uphold the standards and doctrinal position of Camp Ao-Wa-kiya (a copy of the doctrinal statement may be obtained at I hereby release and agree to hold harmless from liability any person or organization, whether listed or not, who provides information or references about me to Camp Ao-Wa-Kiya. I waive any right I might have to inspect references provided on my behalf. I certify that I have neither been convicted of, nor am I the subject of pending charges, for any offence involving actual or attempted child abuse or sexual molestation in any jurisdiction.

If you have any questions about the application process please contact Pastor Mike Deen at or (231) 861-2466