Child and Youth Worker Application (Revised)

Personal Information

Name

Address

This address will receive a confirmation email

Phone

Birthdate (you must be 12 or older)

Maiden Name and/or or Alias (Write N/A if not applicable)

Social Security Number (Required if over 18, if under 18 write N/A)

Ministry Information

Why would you like to work in Children's Ministry?

Please share your Christian testimony and story of salvation (if you are unsure or uncertain please note as well)

If you have been attending Gospel Life Church for less than 5 years, please list any other churches (name, city, State) you have regularly attended during that time frame: (Please also note if you were involved in Children's ministry at any of those churches)

Personal History

Have you lived in Pennsylvania continuously in the past 10 years?

Yes No

Have you been convicted of a felony or sex crime within the previous 5 years?

Yes No

If yes, please explain:

Have you ever been accused and/or convicted of a crime of any nature?

Yes No

If yes, please explain:

Do you have any communicable diseases, such as TB, Hepatitis B, AIDS, etc.? (Note: If in the future you do contract a communicable diseases please inform your children's ministry leader.

Yes No

If yes, please explain:

Note: If you experienced any abuse or neglect as a child you may be aware that emotional ramifications sometimes occur in adulthood. Working with children could possibly trigger repressed emotional repsonses. The pastor at Gospel Life Church is available to counsel with you and/or direct you to Christian counseling services at any time that you feel a need for such help.

References

Please list three (3) non-family references, including their addresses and phone numbers.
If possible, please include at least one reference who has observed you in ministry.

Reference 1

Name

Phone

Reference 2

Name

Phone

Reference 3

Name

Phone

Applicant's Statement

The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children's work. I understand that this application will be kept strictly confidential.

I have read the Children and Youth Worker's Policy of Gospel Life Church, and I agree to be bound by this policy and to refrain from unscriptural conduct in the performance of my services on behalf of the church.

*Electronic Signature

*By entering my name in the above box, I am providing my digital signature on this form and stating that I have answered each question above truthfully to the best of my knowledge.

Date

Child and Youth Worker Application (Revised)

Description

Please Fix the Following