APPLICATION
FOR CHILDREN’S AND YOUTH WORKERS
First Assembly of God
56522 Hwy. 54 West
Zephyrhills. FL 33541 (813)
788-3490
This application is to be completed by all applicants FOR any
position (volunteer or compensated) involving the supervision or custody of
minors, It is being used to help the church provide a safe and secure
environment FOR those children and youth who participate in our programs and
use our facilities.
QUALIFICATIONS FOR CHILDREN’S AND YOUTH WORKERS
Christians who are in places of responsibility in the church
are required to be examples in faith, conduct and business affairs. To maintain
a high standard for workers is one of the best ways to present Christ to the
people of our community. Therefore, the following guidelines will be required
of any person who works in youth or children’s ministry at First Assembly of
God.
1. Must be in agreement with the
tenets of faith of First Assembly of God.
2. Must be a member of First
Assembly of God, and completed the membership class.
3. Be able to make a minimum
six-month commitment.
4. Be loyal to the pastor and
vision of First Assembly of God.
5. Be faithful to selected
ministry position.
6. Live by acceptable Christian
conduct standards, always striving to be more righteous and holy before God.
7. Attend all workers meetings.
8. Be faithful in regular church
attendance, with a minimum attendance of one service per week other than our ministry service.
9. Be at designated place of
ministry a minimum of thirty (30) minutes before start of service.
10. Be dressed appropriately and
neatly.
11. Give a minimum of thirty (30)
days notice of resignation.
PERSONAL
INFORMATION
Name: Home Phone ( ) .
Last
First Middle
Alias (or other names-you have
gone by):
.
Present address: .
Number Street City State Zip
Social Security # - - Birth Date
Place of Employment Work Number ( ) .
Drivers License # State .
Marital Status: r Married r Single r Engaged r Widowed
r Separated r Divorced
r Remarried
Please check all that apply to
you:
ruse tobacco
r drink alcoholic beverages ruse
illegal drugs
Are you a Christian? When were you saved? .
Have you been baptized in
water(Acts 2:38)? When? .
Are you baptized in the Holy
Spirit (Acts 2:4)? When? .
Name of church of which you are a
member? .
How long have you been in
attendance at that church? .
If not First Assembly of God, how
long have you been in attendance here? .
List (name and address) all other
churches you have attended regularly during the past five years. .
.
.
List all previous church work
involving youth (identify church and type of work). .
.
List any gifts, callings,
training, education, or other factors that have prepared you for children /
youth work: .
. Have you ever been convicted of a
criminal offense (excluding minor traffic violations)?
If so, please explain: .
.
Have you ever been accused
of and/ or convicted of child abuse or a crime involving actual or
attempted sexual molestation? If yes, explain .
.
Have you been involved in
homosexual activity within the last ten (10) years? .
If yes, explain
.
Do you
presently have any communicable diseases (including HIV or AIDS)? . If yes, explain .
Have you ever been treated for
and/or diagnosed with any mental illness?
.
.
Were you, or any member of your
immediate family, abused as a child? .
.
Do you have any physical handicaps
or conditions preventing you from performing certain types of activities
relating to youth or children’s work? If yes, please explain .
What type of children/youth work
do you prefer? .
.
On what date would you be
available? .
Minimum length of commitment: .
Would you be willing (if able) to
provide transportation to church for those involved in your ministry? r Yes, regularly. r
Yes, on an ”as needed” basis.
r No, except
in emergencies. r No, not at all.
Will you be able to arrange your
work schedule to attend all scheduled functions of your chosen ministry? .
PERSONAL REFERENCES
(Not former employers or
relatives)
Name: .
Address: .
Telephone: .
Name: .
Address: .
Telephone: .
PASTORAL REFERENCES
(Former Senior Pastor, Associate Pastor, or Ministerial
Supervisor)
Name: .
Address: .
Telephone: .
For Office Use Only:
Reference 1: Date .
Reference 2: Date .
Reference 8: Date .
Pedophile Web Listing Search : Date: .
Pastor Approval Signature: Date .
Ministry Leader Approval:
Date .
APPLICANT’S STATEMENT AND
AUTHORIZATION FOR RELEASE OF INFORMATION
The information contained in this application is correct to the best of my knowledge. I authorize, without reservation, any references or churches listed in this application to give you any information they may have regarding my character and fitness for children/youth work, and I release all such references from liability for any damage that may result from furnishing such evaluations to you. In addition, I authorize the pastoral staff of First Assembly to conduct a felony police search as part of the screening procedure, and I understand that all such information will be held in the strictest of confidence. Should my application be accepted, I agree to be bound by the Constitution, Bylaws and policies of First Assembly and to refrain from unscriptural conduct in the performance of my services on behalf of the church. I understand that I will be required to attend a minimum of one service per week (not including ministry service) in the sanctuary in order to continue my ministry. Because First Assembly values the safety and well being of their children, I understand that acceptance of this application may require a fingerprint registration with the local sheriff’s department. I understand that this is a precautionary measure only, and I will be willing to comply with such procedures.
Applicant’s Signature Date .
Witness
Date .