Grace Chapel

VOLUNTEER

Minor Personnel Form

Application for work with children, youth, or adults

We recognize that this form is extensive, but ask for your patience in completing the form in its entirety. Your cooperation will assist church leaders in their efforts to provide a secure environment for you as a volunteer, as well as the children, youth, and adults who participate in our ministry programs and use our facilities. Your responses will be maintained confidentially, although there may be circumstances where such information may be provided on a “need to know” basis to individuals working with our ministry and to other individuals in order to evaluate your application and/or comply with applicable legal requirements. If you prefer that your application only be viewable to Pastors and elders, please indicate on this cover page.

NOTE: If you live in a state where laws exempt you from providing any of the information requested below, you need not answer the questions requesting such information. For example, you need not disclose information that is contained in sealed or expunged court records, or that involves a criminal arrest that did not result in a conviction.

* Indicates required question

General Info:

Full Name (first, middle last)

Birthdate

Parent/Guardians Full Name

Main Phone Number

Parent/Guardian's Relationship to Minor

Mother

Father

Grandparent

Legal Guardian

Parent/Guardian's Signature

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Current Address

Country/Region

Address

City

Zip / Postal code

Do you regularly attend church services? (two or more services a month)

Yes

Which church do you consider to be your home church?

Personal Testimony

Have you received Jesus Christ as your Lord and Saviour?

Yes

Have you been water baptized?

Yes

Have you been baptized in the Holy Spirit?

Yes

Unsure

(Is there evidence of both gift(s) and fruit(s) of the Spirit at work in your life? Acts 2:17, 1 Cor. 12, & Gal. 5:22-23)

Briefly outline your spiritual journey, including when you received Jesus Christ as a Savior:

Ministry Experience

Have you taken any courses or received any training that would equip you for Christian ministry? If so, please explain:

Ministry History

Please list churches you have attended and the ministry organizations in which you have participated: (name of church and location)

Please list any present and previous ministry experience and the overseeing Pastor or supervisor:

Briefly share your motivation for wanting to serve in the ministry of this local church:

Volunteer Availability

On what date would you be available to begin serving?

Describe any condition or limitation that might restrict or prevent you from performing certain activities involved in the volunteer position for which you are being considered.

Do you have any contagious or infectious disease or condition which could be transmitted to others in the volunteer work you would be performing?

Yes

Explanation of contagious or infectious disease or condition that can be transmitted.

Background

Have you ever been convicted of a criminal offense (felony or misdemeanor, except for minor traffic violations)?

Yes

You will need to answer "YES" if you have entered into a plea agreement, including a deferred sentence or a deferred judgement arrangement, in connection with a criminal charge.

Statement

The responses I have provided in completing this application form are complete, truthful, and accurate. I hereby authorize Grace Chapel (hereunto referred to as “the Church”) to make inquiries concerning my background in connection with evaluating the information I have provided on this form and the application process.

I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENT OF IT, AND I SIGN THIS RELEASE AS MY OWN FREE AND VOLUNTARY ACT.

I understand that my service with the Church shall be volunteer service. In addition, my volunteer service shall be at-will, and the Church shall be entitled to terminate my services at any time, with or without cause or advance notice. I understand and agree that I am not an employee of the Church and that I have no expectation of future employment. As a volunteer, I have no entitlement to or expectation of compensation, health insurance or other employee benefits, or unemployment or worker’s compensation insurance benefits.

I affirm that I will strictly comply with all policies and procedures of Grace Chapel, including but not limited to its Safe Place Plan. If at any time I find that for any reason I am unable to support the vision, policies, procedures, or doctrine of this church, I will resign my volunteer position. I understand and agree that failure by me to abide by such policies and procedures may result in my immediate dismissal at the discretion of the Church.

I confirm that I have read this statement in full and understand it.

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