TIME Questionnaire

CA TIME Program
Personal Reflection Questionnaire

Applicants who complete and submit this form before April 1, 2023 will be given priority consideration.
Thank you for your interest and willingness to participate in the Camp Assurance TIME Program.

* Indicates required field

Name *

First

Last

Email *

Salvation Testimony *

Have you had doubts about your salvation? *

If Yes, please explain. *

Have you been baptized since you got saved? *

What local church are you a member of? *

If not, please explain. *

Since your salvation, in what areas of your life have you seen definite spiritual growth? *

Out of 7 days, how many days on average do you have devotions? *

In what areas do you consistently struggle? *

When do you have your alone time with God? *

What do you do during your alone time with God? Please explain, be specific. *

If you could change one thing about yourself, what would it be? (past, abilities, appearance, family, lifestyle, schooling, etc.) *

Are you actively sharing the gospel with the lost in your neighborhood and community? If yes, please list two examples in the last 6 months. *

Do you kindly confront friends about sinful choices in their lives? If so, please list two examples in the last 6 months. *

Have you felt pressured at times, by friends, to do things you know are wrong? *

What types of things do they try to pressure you into doing? *

Explain how you tend to respond to that pressure? *

Describe any chores at home for which your parents regularly depend on you? *

On a scale of 1-10, rate yourself on how well you handle the responsibilities you have at home. *

Would your parents say you have an obedient attitude at home? *

Would your parent say you have a genuine love and compassionate spirit towards other family members? *

Would your parents say you have a serving and helpful spirit? *

Have you had a major conflict with your parents in the past? *

Has it been resolved to your parents satisfaction? *

Is there, at this time, a continuing conflict with your parents? *

If yes, please explain. *

What are some hobbies and extra-curricular activities that you enjoy? (Music, sports, clubs, etc.) *

If you play an instrument, what do you play? *

What part would you sing in a choir? *

Give 5 adjectives that best describe your personality. *

How would you rate your three closest friends? *

Describe your future plans (short-term and long-term) for your life. *

Please explain why you would like to attend TIME and what you would like to see accomplished in your life, if accepted? *

Service weeks for TIME Program (Please select a minimum of two sessions, but mark all that you are available.) *

Teen Camp 1 (June 19-23, 2023) Junior Camp 1 (June 26-30, 2023) Primary Camp (July 11-13, 2023) Junior Camp 2 (July 17-21, 2023) Teen Camp 2 (July 24-28, 2023)

Please list your preferences for Service weeks, using a 1-5 scale. (1 = First Choice, 2 = Second, etc.) *

Upload Digital Applicant Photo *

Max file size: 20MB

All of the previous answers truthfully reflect my current attitude and actions. I agree to abide by ALL staff policies and procedures, if accepted into the TIME program, and understand that if I do not I will be confronted by an administrator of Camp Assurance. Failure to comply with policies after a warning may lead to termination from the TIME program.

TIME Applicant's Digital Signature *

First

Last

Date Signed *

I have reviewed my child's Personal Reflection Questionnaire and am satisfied with the accuracy of the information provided. I understand the TIME Program requirements and agree to allow my child to participate.

Parent/Guardian's Digital Signature *

First

Last

Date Signed *

**Each applicant will be notified using the email address provided by May 1, 2023 if accepted into the TIME program.

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CA TIME ProgramPersonal Reflection Questionnaire

CA TIME Program
Personal Reflection Questionnaire