First Name
*
Last Name
*
Date of Birth
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Home Phone
*
(###)
###
####
Mobile Phone
*
(###)
###
####
Work Phone
*
(###)
###
####
Email
*
Campus you are applying to serve at
*
Age level interested in serving
*
Days/Hours Available
*
What is the approximate date you became a Christian?
*
Briefly share your experience of salvation and your spiritual growth since then.
*
How long have you attended New Life Church?
*
What is the name and address of the church you attended before New Life Church?
*
Why do you want to work with our children?
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Have you had any opportunities to work with children in the past? If so, in what capacity and for how long?
*
List any spiritual gifts, training, education, or other factors that have prepared you to work with children:
*
Are you certified in first aid / CPR? If yes, when does your certification expire?
*
Reference 1
*
List three references (they must be people who have known you for at least two years):
First Name
Last Name
Relationship:
*
Contact Number:
*
(###)
###
####
Reference 2
*
First Name
Last Name
Relationship:
*
Contact Number:
*
(###)
###
####
Reference 3
*
First Name
Last Name
Relationship:
*
Contact Number:
*
(###)
###
####
Is there anything we should know about you, your health, or anything else?
*
Have you ever been accused of, or prosecuted for any abuse or sexual misconduct or abuse with a child or another adult?
*
Have you ever been arrested for any reason?
*
Have you ever been convicted or accused of a crime?
*
If you answered yes to any of the last five questions, are you willing to come and talk to the pastor about it?
Applicant's Statement
*
The information contained in this application is correct to the best of my knowledge. I authorized New Life Church to contact the references I have listed and perform a background investigation. I release my
references from liability for any damage that may result from furnishing such evaluations to New Life Church. I waive my right to inspect these references.
Signature
*
Date
*
MM
DD
YYYY
New Life Church believes that the safety of our children and youth is a priority. We are committed to creating a safe place for children and youth to treasure God and grow in Jesus Christ. To ensure the safety of children and youth, protect volunteers and paid staff from false accusations, and to safeguard the reputation of our church and the Christian community, all child and youth workers, whether paid or volunteer, agree to follow the security protocols described. in the Child and Youth Workers Policy of New Life Church. By signing below, I acknowledge that I have read the policy and will follow the security protocols outlined in it.
*
Signature
*
Date
*
MM
DD
YYYY
