Other names previously used
Maiden, etc.
Phone number
Phone type Mobile Home Work Other
Gender
Select… Male Female
Marital status
Select… Single Married Widowed
Are you a member of Kenmore Alliance Church?
Do you attend regularly (2 or more services a month?)
In a brief paragraph, please outline your spiritual journey, including when you received Christ as your Savior.
Please list the churches you have attended and the ministry organizations in which you have participated in the last five years.
Please list present and previous ministry experience and location
Briefly share your motivation for wanting to serve in the ministries of this church
When are you available to serve?
Check all that apply
What age group would you like to work with?
Check all that apply
Describe any limitations or medical concerns, if applicable
These are things that might limit your ability to perform needed tasks or compromise the safety of our kids.
Have you ever been convicted of a criminal offense (felony or misdemeanor, except for minor traffic violations)?
Have you ever been convicted of a sexual offense, offense relating to children, or crime of violence (that is not covered in question 1)?
Have you ever been reported to a social services agency, law enforcement authority, child abuse registry, or similar organization regarding abuse or misconduct involving children?
Have you ever been the subject of a civil lawsuit involving sexual misconduct, sexual harassment, or other immoral behavior or conduct involving adults or children?
Have you ever been the subject of a complaint or disciplinary proceeding against a professional license or other license held by you, including, but not limited to a license to provide child care or similar services?
Have you ever been the subject of any disciplinary action, transfer or dismissal, or been named as a defendant in a civil lawsuit, as a result of an accident or mishap involving children?
Have you ever been subject to any disciplinary action (including discharge) or investigation by a church, religious or other organization or by an employer?
Do you have any drug, alcohol, or substance abuse problems?
1. Leader of a ministry you serve(d) in
Name, phone number, relationship and length of time known
2. Friend
Name, phone number, relationship and length of time known
Applicant's Signature *
By entering my name below, I agree to the above statements and release this information into the volunteer process, knowing that an interview, reference check and background check will be performed in consideration for a position in ministry.
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