CommentsThis field is for validation purposes and should be left unchanged.Please fill out this form if you've received confirmation that you've been accepted as a teacher in the Children's Program this year. We need this information to 1, confirm your place in the program and 2, finalize program logistics with program leaders! Please contact us at connect@npines.org if you have any questions.Please note, if you leave or refresh this page before successfully submitting the form, your progress will not be saved. To avoid losing your work, you can write the longer answers in a notes or document application and then copy and paste into the form fields.Section One: Your InformationName(Required) First Last Nickname or Preferred NameFor initial communication, our system will use your first name, but it is helpful to know if you go by a nickname.Please confirm which weeks you will serve:(Required) Week 1 Week 2 Both weeks Is this your first time on staff for Northern Pines?(Required) Yes No One-way Mileage(Required)Distance from home to Green Lake Conference CenterEmail(Required) Enter Email Confirm Email Mailing Address(Required) My address has not changed since I applied My address has changed since I applied I don't remember which address I use for my application Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Section 2: ScreeningDo you agree to be present for all staff development activities?(Required)Staff training starts on the afternoon of the Saturday before camp. Yes No Please explain your expected absence from staff training(Required)Statement of Faith(Required)Do you agree with the position of Northern Pines on this matter (Statement of Faith), and, that as a member of the staff, you will uphold it in word and action? Read our Statement of Faith here Yes No Standards of Behavior(Required)Do you agree with the position of Northern Pines on this matter (Standards of Behavior), and, that as a member of the staff, you will uphold it in word and action? Read our Standards of Behavior here Yes No Have you ever been convicted or pleaded guilty to a crime?(Required) Yes No If yes to convicted or plead guilty to a crime, please explain(Required)Any additional comments?Section Three: Lodging, Meals, Transportation, & Weekend LogisticsDietary Needs(Required)Special dietary meals are available for an additional $50 per person, per week. If you need a special meal (Gluten-free, dairy-free, etc.), please submit the special dietary request form I will not need special dietary meals I will need special dietary meals and already submitted that form I will need special dietary meals but have not submitted that form yet Transition Weekend(Required) I'm only serving one week I'm serving Week 1, attending as a conferee week 2 I'm serving Week 2, attending as a conferee week 1 I'm serving both weeks Transition Weekend Lodging (w1)(Required)For Week 1 teachers staying to attend Week 2 as conferees, there is a $99 charge to stay at GLCC for the Transition Weekend (Saturday night between Week 1 and Week 2). Meals are not provided. I will stay on campus for the transition weekend ($99 Charge) I will not be on campus for the transition weekend and will not need lodging or meals for Saturday (lunch & dinner) or Sunday (breakfast & lunch) Transition Weekend Lodging (w2)(Required)For Week 1 conferees staying to serve as Week 2 teachers—or teachers serving both weeks—there is no charge to stay at GLCC for the Transition Weekend (Saturday and Sunday between Week 1 and Week 2) because they need to attend Saturday training. Food and lodging are provided. I will stay on campus for the transition weekend I will not be on campus for the transition weekend and will not need lodging or meals for Saturday (lunch & dinner) or Sunday (breakfast & lunch) Lodging I agree to room with another teacher I am serving/attending with a spouse I prefer my own room ($520 Charge) Second Week Lodging I'd like to stay in the same lodging/room both weeks I'm camping, or in a house—or for another reason—do not want the same lodging both weeks I'm flexible Summary of Fees & PaymentWeekend Stay Price: Individual Room Price: How would you like to pay?(Required) Pay now online Will mail a check to PO Box 750 Lakeville MN 55044 Will pay via Zelle at npzelle@npines.org I will volunteer over the weekend and/or have made alternative plans with Julie Transaction FeesFor online payments. This covers our fees so that 100% of your payment goes to Northern Pines. Thank you! Price: $50.00 Total due for transportation and weekend Credit Card(Required) CAPTCHA
