Volunteer Application Form

Confidential YOUTH Volunteer Application for
Children and Student Ministries

This application is part of a comprehensive effort to provide a safe environment for the children/youth entrusted to our care at Valley Church.

BEFORE filling out this form, you may wish to prepare the following information:
1. All churches you have attended in the past 5 years. Include their names, city/state and the dates you attended.
2. Three personal references (a relative or adult family friend) and their contact information.
3. A parent/guardian to review and sign your application.
APPLICANT INFORMATION
First Name
Last Name
Middle Name
Gender
Date of Birth

MonthDayYear
Place of Birth
City, State
Current Address

Street Address

Apt.

CityState

Zip Code
How long have you lived at this address?
Phone Number to contact you at:
Who does this number belong to?
Email to contact you at:
School
PARENT INFORMATION
Mother's Full Name
Mother's Cell Phone
Mother's Email Address
Father's Full Name
Father's Cell
Father's Email Address
Church Attendance
Name of Church Attending
Are you a regular attendee?
How long have you attended?
Please list all the churches you have attended in the last 5 years, starting with the most recent, including Valley Church.
Current Church
City, State
Current Church
Dates Attended
Current Church
Previous Church #1
City, State
Previous Church #1
Dates Attended
Previous Church #1
Previous Church #2
City, State
Previous Church #2
Dates Attended
Previous Church #2
WORK EXPERIENCE
Have you ever worked (or volunteered) at a church in a ministry or other work involving children or youth?
If YES, please list where you have worked and what your role was (including Valley Church):
Church/Organization #1
City, State
Church/Organization #1
Your Role
Church/Organization #1
Church/Organization #2
City, State
Church/Organization #2
Your Role
Church/Organization #2
Church/Organization #3
City, State
Church/Organization #3
Your Role
Church/Organization #3
PERSONAL REFERENCES
Please list 3 personal references (a relative or adult family friend), including their phone number and email address.
Personal Reference #1*
Name
Phone Number
Email
Personal Reference #2*
Name
Phone Number
Email Address
Personal Reference #3*
Phone Number
Email Address
ADDITIONAL INFORMATION
Have you ever been charged with or convicted of any criminal offenses?
If YES, please give the date, place, nature and current status of the offense.
Have you ever been hospitalized or treated for alcohol or substance abuse?
If YES, please explain.
Would you object to the church conducting a criminal background check on you?
In your own words, please explain WHICH AGE(s) you want to volunteer with and WHY you want to work or volunteer for this ministry of the church.
I certify that the information contained in this application is correct, complete, accurate, and not misleading in any material way. I give my approval for you to check any references I have given, including churches, individuals, or official government records listed in this application, and also to check any sources not listed in this application which may have information that in your opinion will help evaluate my application.

I give my permission for any of the references you check to give you any information that they may have regarding my suitability and fitness for children's/youth work. I fully and voluntarily release all such references from any liability they might otherwise have for furnishing any information to you, including stating their own subjective opinions. I waive any right that I might have to read or examine information given to you by my references.

If I am accepted for any position at Valley Church, I agree to abide by all policies of the church, including the corporate Articles and Bylaws, and the stated policy of the church.

I understand that the position in which I am applying is strictly an "at will" position, and that the church or I may end the position at any time, without liability.
Signature of Parent/Guardian

Powered by Jotform SignClear
Date

MonthDayYear
Youth Signature

Powered by Jotform SignClear
Date

MonthDayYear
If you'd like a copy of this form, please provide your email address:
Should be Empty:

Confidential YOUTH Volunteer Application forChildren and Student Ministries

APPLICANT INFORMATION

PARENT INFORMATION

Church Attendance

WORK EXPERIENCE

PERSONAL REFERENCES

ADDITIONAL INFORMATION

Confidential YOUTH Volunteer Application for
Children and Student Ministries