Children's Ministry Volunteer Application - Pillar Church of Stafford

Your name *

Email address *

Address *

Phone number

Are you physically able to care for or assist in caring for children?

Yes

Spiritual Background

Provide a brief testimony of how you came to faith in Jesus Christ & how you are growing in your relationship with God: *

Church & Ministry Background

Are you a member of Pillar Church of Stafford?

Yes

Are you a regular attender of Pillar Church of Stafford?

Yes

List any gifts/talents/education/experience/skills that you feel would be useful in children’s ministry:

List any previous experience in childcare or children’s ministry:

Do you have children of your own?

Yes

If you have children, what are their ages?

Are you currently CPR certified?

Yes

Are you currently First Aid certified?

Yes

Background Screening

Have you ever been denied the opportunity to work with children at a church or other setting? *

Yes

Have you ever been accused of, charged with, or alleged to have, or have you ever committed any act of neglecting, abusing, or molesting any child? *

Yes

Have you ever been convicted of a criminal offense, including the illegal use or sale of drugs? *

Yes

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

Is there any fact, circumstance, or pattern involving your background that would make it inappropriate for you to serve with minors? *

Yes

Additional Information:

Personal References

Please list 3 personal references with relationship to you and telephone/email contact information

Consent for Background Check

Every applicant, regardless of criminal record must complete this section. Information will be kept confidential and used only for background check purposes.

Type full legal name below to provide background check consent *

I hereby request and authorize the release of any information which pertains to any record of convictions contained in law enforcement files or in any criminal file maintained on me whether local, state, or national. I hereby release local, state, and national law enforcement agencies from any and all liability resulting from such disclosure.

Social Security Number *

Driver's License Number *

Driver's License State *