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Volunteer Service Application:
The information contained in this application will be kept confidential. It will be disclosed only to those who have a genuine need to know in order to carry out their responsibilities as required by law.
GENERAL INFORMATION:
Mr./Mrs./Miss:

Maiden Name:

Address:

City,State,Zip Code:

Number of Years at this Address:

Home Phone:

Work Phone:

Date of Birth:

Place of Birth:

Social Security Number:

Driver's License Number & State:

Spouse's Name:



PERSONAL REFERENCES:
List two people you have known for at least five years, who are not related to you and have a definate knowledge of your character and qualifications to work with children.

REFERENCE #1:
Name:

Nature of Association:

Address:

City,State,Zip Code:

Home Phone:

Work Phone:

Length of Time Known:

Occupation:


REFERENCE #2:
Name:

Nature of Association:

Address:

City,State,Zip Code:

Home Phone:

Work Phone:

Length of Time Known:

Occupation:


SPIRITUAL JOURNEY:

Describe briefly how you came to personally know Jesus Christ as your Lord and Savior:

Name of Church and how long have you regularly attended church:

Please describe previous and current ministry experience at your church and the dates you served:


Please describe your ministry experience at other churches, including the name and address of the church and the name of the person to whom you reported.

Ministry Experience:

Name of Church:

Address:

City:

State,Zip Code:

Phone Number:

Name of Contact:



Ministry Experience:

Name of Church:

Address:

City:

State,Zip Code:

Phone Number:

Name of Contact:



Ministry Experience:

Name of Church:

Address:

City:

State,Zip Code:

Phone Number:

Name of Contact:


PERSONAL SITUATIONS:

Have you ever been convicted of any offense against the law? (you may omit minor traffic violations)

Yes
No

If yes, please explain:




Have you ever been accused, charged or alleged to have committed any act of neglecting, abusing or molesting any child? If yes, please explain in detail, providing date and place of incident.

Yes
No

If yes, please explain:




Have you ever been concerned that you may have an addiction to drugs, alcohol, pornography, or any other addiction; or has anyone ever suggested that you may have a problem with any of the above?

Yes
No

If yes, please explain:




Are there any physical limitations that may impair your ability to serve in any area of the Children's Ministry, or have you ever been treated for a psychiatric disorder?

Yes
No

If yes, please explain:




This section is needed to set up a signature block:
(Please enter the person who will sign the form)
Full Name


 
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