Application to Volunteer with Minors

After reading the child protection policy, this application is the next step in the process to help the church provide a safe, nurturing environment for our children. Any question could be discussed in more detail with a ministry supervisor during the follow-up interview.

Your name *

Email address *

I have read the Child Protection Policy and agree to abide by it. By entering your full name below, you agree that it will act as your digital signature. *

Phone number

Address *

Gender *

How long have you lived this address? *

How long have you been attending FCBC? *

Are you a member of FCBC? *

Are you 18 years or older? *

Why do you want to work with children, youth or both at the church?

List any skills, training, spiritual gifts or other experiences that you feel could help you while volunteering in this ministry:

If you have been attending FCBC less than 4 consecutive years, list the most recent church name with the city & state, whether regularly attending or as a member:

Have you ever participated in, been charged with, convicted of, or pled guilty or “no contest” to child neglect, or any form of abuse of children or adults? *

List any social media sites you are on:

Please provide phone and Email for 2 references. Preferably a non-family member, and one opposite gender reference. If possible, include references where past work with minors was done.

Release Statement

I attest and affirm that the information provided is accurate and truthful. I understand any intentionally false or inaccurate information provided by myself on this application shall be grounds for denial of the application.

I authorize FCBC to contact all individuals, organizations, and references listed on this form. I also authorize any such person, church, or organization to provide this church with information and opinions relating to my background and/or qualifications. I agree to release from liability any person, church, or organization providing information related to me, including those persons I have listed as references, as well as contact persons from my previous volunteer work or employment with children.

I specifically authorize FCBC to undertake a criminal background check concerning my past if 18 years or older.

I understand and agree that any information received from the background check and application verification will not be disclosed to me except as required by law. I hereby waive any right I may have to inspect any information provided about me by any person or organization identified by me on this form.

I promise to exhibit appropriate behavior and conduct when working with children. I hereby affirm that I have not resigned from or been terminated from a position for reasons relating to abuse or misconduct, as defined in the Policy statement. I further affirm that I am not a registered sex offender nor do I have any pending or resolved cases with the civil authorities concerning the welfare of children. I affirm that I will not use my position of trust in the church to abuse or harm any child.

By entering your full name below, you agree that it will act as your digital signature. *

* PARENTAL SIGNATURE - IF APPLICANT IS A MINOR

I affirm that I am the parent/legal guardian of the applicant. With my signature below, I attest and affirm that the information provided is accurate and truthful. I further attest and affirm that I am not aware of any harmful tendencies or traits of the applicant that may pose any threat to children or youth.

By entering your full name below, you agree that it will act as your digital signature.