Children’s Ministry Application

This survey is to be completed by all those desiring a ministry position involving the supervision or custody of minors. It is being used to help the church provide a safe and secure environment for those children who participate in our programs and use our facilities.

Please print all information. Thank you!

Name ____________________________________________________ Date ____________________

Last First Middle

Address ____________________________________________________________________________

Street City State Zip

Home Phone ____________________ Work ___________________ Cell _____________________

E-mail Address __________________________________ @ ______________________________

Spouse’s Name ______________________ Marital Status: Single Married Divorced Widowed

# of Children __________________________ Ages ____________________________

Occupation: _______________________Place of Employment: ________________________

Birthdate: ________ /________ /________ Sex: _____ Male _____ Female

Driver’s License #: _______________________ Expires: ___________ State: ____________

Do you have a personal relationship with Jesus Christ? ____________ Briefly describe: ___________________________________________________________________________________

___________________________________________________________________________________

How long have you attended First Church? _______________________

What area of ministry do you desire to be involved in? ___________________________________________________________

____________________________________________________________________________________________________

Please check the services or groups you regularly attend:

‘ Sunday, 8:30 a.m. _____ Sunday, 10:30 a.m. _____ Other ____________________

Have you attended the Welcome Class? ______ Yes ______ N o

What leadership/volunteer experience have you had with children?

_____________________________________________________________________________________

Please identify place and type of work, list supervisors.

Place

Type of Work

Supervisor

Age and Grade Preference:

_____ Nursery/Toddler _____ Preschool (ages 4 & 5) _____ Kindergarten

_____ First Grade _____ Second Grade _____ Third Grade

_____ Fourth Grade _____ Fifth Grade _____ Sixth Grade

Teaching Hour Preference:

______ Weds. eve. ______ Sunday, 8:30 a.m. ______ Sunday, 10:30 a.m.

Please list any other First Church ministries that you are involved in: _______________________

____________________________________________________________________________

Local Personal References: (Must be over 18 years of age and non-related to you.)

Name _________________________________________________________________________

Address _______________________________ City _________________ Zip__________

Phone __________________________ Relationship _____________________________

Name _________________________________________________________________________

Address ______________________________ City _________________ Zip___________

Phone __________________________ Relationship _____________________________

Name _________________________________________________________________________

Address ______________________________ City _________________ Zip___________

Phone __________________________ Relationship _____________________________

The questions listed below are part of our interview process in order to help provide a safe and secure environment for our children. All information is held strictly confidential by the Children’s Ministry Staff. Answering yes to any of the questions may not necessarily preclude your involvement in Children’s Ministry. Thank you for your understanding.

Have you had any painful experiences in your life that have better equipped you or that may hinder you from a productive ministry with children? ______ Yes ______ N o

Would you like to meet with a pastor regarding this circumstance? ______ Yes ______ N o

Do you use illegal drugs?	Yes	No
Have you ever been hospitalized or treated for alcohol or substance abuse?	Yes	No
Have you ever been arrested for a criminal offense excluding minor traffic violations?	Yes	No
Have you ever been accused, arrested, or convicted for any sexually related crimes?	Yes	No
Have you ever been accused, arrested, or convicted for any abuse related crimes?	Yes	No

If you answered yes to any of the above questions, please explain ________________________________________________________________________________

_________________________________________________________________________________________________________________________________

Applicant’s Statement

The information contained in this application is correct to the best of my knowledge. I authorize any references, churches, or other organizations listed in this application to give you any information they may have regarding my character and fitness for working with children. I release all such references from liability for any damage that may result from furnishing such evaluations to you. I understand that any omission of material fact on this application may be ground for rejection of this application.

First Church Teacher’s Covenant

Having committed to the ministry of teaching and the habits essential for spiritual maturity,

I commit to.....

_______ Prepare for ministry by maintaining my personal relationship with Jesus Christ.

_______ Support the teaching ministry by praying for the church and Children’s Ministry Staff, Sunday School Teachers, and specifically the children in my class.

______ Cooperate with other ministries and place the greater good of the whole body over the needs of my ministry.

______ My personal growth and education by participating in teacher training, Welcome Class, and Membership Classes.

Should my application be accepted, I agree to follow the policies of First Church and to refrain from unscriptural conduct in the performance of my services on the behalf of the church. I understand that the personal information will be held confidential by the professional church staff.

Applicant’s Signature _____________________________________________ Date _____________________