Children's Ministry Adult Application

Thank you for your interest in serving on our Children's Ministry. In this form, you will be asked to provide personal information and references, as well as affirm church beliefs. Please allow approximately 30 minutes to complete this form. Thank you for helping us protect our church's children!

Please note: This form should be completed in one sitting. Your progress may not be save if you come back to it at a later time. Thank you!

Your name *

Email address *

Phone number

Birthdate

Gender

Address

Employment History *

Residence History *

Education Experience *

Questionnaire

Because we care for and desire to protect children, we ask that you answer the following questions truthfully. It is the policy of Church of the Incarnation to report any suspicions or allegations of child abuse to the relevant state authorities.

Why do you want to teach or work with Children? *

Have you ever worked with Children before? Where, when, and in what capacity? *

Do you have any physical conditions that might limit you from performing certain activities? *

Are you aware of having any traits, tendencies, or limitations that could pose any threat to children, youth, or vulnerable adults? *

What skills, strengths, or experiences do you have that could benefit the babies, children, and youth in the ministries of Incarnation? *

Have you ever been convicted of, or are you presently charged with any crimes including domestic violence, child pornography, child abuse, neglect or molestation, or any crime related to persons? *

Have you ever physically or sexually abused a child? *

Have you ever been convicted of or pleaded guilty or no contest to a criminal offense of any kind? *

Have you ever participated in or been accused, convicted, or pleaded guilty or no contest to abuse or any sexual misconduct, or had such a record expunged? *

Has anyone ever accused you of physically or sexually abusing a child? *

When did you begin regularly attending Church of the Incarnation? *

What other ministries are you involved in at Church of the Incarnation? *

Prior Church History

If you have been a regular attender of a church other than Church of the Incarnation in the past five years, please fill out the following questions. If this does not apply, please respond with "N/A".

Previous Church Name *

How long were you a part of this church? *

Previous Church Pastor's Name *

Previous Church Phone Number *

Previous Church Ministry Experience *

References

Please notify the following references that Jess Palmer from Incarnation will be calling them soon.

1. Personal Ministry Reference (not a relative):

Personal Ministry Reference Name: *

Personal Ministry Reference relationship to you: *

Personal Ministry Reference email Address: *

Personal Ministry Reference phone number: *

2. Family Reference:

Family Reference Name: *

Family Reference relationship to you: *

Family Reference email address: *

Family Reference phone number: *

3. Additional Reference (personal or professional, not a relative):

Additional Reference Name: *

Additional Reference relationship to you: *

Additional Reference email address: *

Additional Reference phone number: *

The Nicene Creed

We believe in one God, the Father, the Almighty, maker of heaven and earth, of all that is, seen and unseen. We believe in one Lord, Jesus Christ, the only Son of God, eternally begotten of the Father, God from God, Light from Light, true God from true God, begotten, not made, of one Being with the Father. Through him all things were made. For us and for our salvation he came down from heaven: by the power of the Holy Spirit he became incarnate from the Virgin Mary, and was made man. For our sake he was crucified under Pontius Pilate; he suffered death and was buried. On the third day he rose again in accordance with the Scriptures; he ascended into heaven and is seated at the right hand of the Father. He will come again in glory to judge the living and the dead, and his kingdom will have no end. We believe in the Holy Spirit, the Lord, the giver of life, who proceeds from the Father and the Son. With the Father and the Son he is worshiped and glorified. He has spoken through the Prophets. We believe in one holy catholic and apostolic Church. We acknowledge one baptism for the forgiveness of sins. We look for the resurrection of the dead, and the life of the world to come. Amen.

I have read the Nicene Creed and am in harmony with it. *

Yes

Release

I authorize Church of the Incarnation to contact all individuals, organizations and references listed on this form in order to verify the information I have provided. I agree to release from liability any person 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 Church of the Incarnation to undertake a criminal background check concerning my past. 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, and 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. By submitting this form, I certify and affirm that the information I have given on this form is true, complete and correct in all respects.

Signature (Full Name): *

Today's Date: *

Please list a few dates and times you would be available for an interview. *

This interview can be completed during the week at the church office or after worship on a Sunday morning.

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