Confidential Volunteer Application Form Sample printable pdf download

Disclaimer

This form is solely for illustrative purposes. State and local laws may vary. It is recommended that each

church solicit the advice of an independent and qualified attorney. Neither LifeWay Christian Resources

nor the Southern Baptist Convention assumes any liability for reliance on this form.

Confidential Volunteer Application Form

_______________________________________________________________________________________

This application is to be completed by all applicants for any position involving the supervision or

custody of minors. It will help our church family provide a safe and secure environment for children.

Personal

Last Name ___________________________ First Name ________________________ Middle Initial ______

Present Address ________________________________________ Social Security # ___________________

City __________________________________ State ______ Zip ___________ Date ___________________

Email ___________________________________________________ Marital Status ___________________

Home Phone ( ______ ) _______________________ Work Phone ( ______ ) ________________________

Occupation _____________________________________________________________________________

Do you have a current driver’s license?

Yes: License number ____________________ State _____

Have you ever been charged with, indicted for, or pled guilty to an offense involving a minor?

Yes

If yes, please describe all convictions for the past five years. _______________________________________

_______________________________________________________________________________________

Were you a victim of abuse or molestation while a minor?

Yes

If you prefer, you may refuse to answer this question.

You may discuss your answer in confidence with one of the ministers rather than answering on this form.

Answering yes or leaving the question unanswered will not automatically disqualify you.

Church

_________________ When did you make your profession of faith in Christ?

_________________ When were you baptized? List any gifts, callings, training, education, or other factors

that have prepared you for teaching. _________________________________________________________

_______________________________________________________________________________________

Are you a member of this church?

Yes—If yes, how long have you been a member? ____________

1. If no, list your church membership contact information in the first church selection on the back of this form.

2. Please list other churches you have attended regularly during the past five years.

3. Include the type of work involving children that you performed.

Confidential Volunteer Application Form Sample