Language
English (US)
Español
Nathaniel Mission
VOLUNTEER APPLICATION
Purpose: To demonstrate our absolute and unwavering commitment to the physical safety and spiritual growth of all of our children. Protect Children, Protect Adults, & Protect the Ministry.
This application will be asking some very personal and private questions. It is our intention to find out more about the people that we are entrusting with minors. The information contained in this application will be treated with the utmost of confidentiality and respect. Our Nathaniel Mission Board has mandated strict criteria for the treatment and storage of Confidential Documents. These instruments will be stored under a double locked system (in a locked file cabinet located in a locked office). No one will have access without proper authorization. The questions contained herein are not designed to offend or to pass judgment, but rather create an environment where a person's past will not hinder the ministries in carrying out their mission in a safe, fun and productive way. This application is to be completed by all adult volunteers involving direct interaction with minors. This is not an employment application.
Legal Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date Picker Icon
Social Security Number
*
Required to do background checks -- must include!
Driver's License Number
Driver's License Number
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Age
*
Gender
*
Male
Female
Other
Race
*
Marital Status
*
Married
Single
Widowed
Rather not say
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Spouse's Name
Church (if attending any)
Emergency Contact Info
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Relationship:
*
Sister, brother, spouse, parent, friend, etc.
Employment/School
We will not contact your employers unless you list them in the reference section.
Present Employer/School
Position/Area of Study
Type of student/emplyee
Part Time
Full Time
Personal Situations
If you are a person who must answer affirmatively to any of the questions below, we may ask to discuss this further with you during your connection process. Please be assured that this does not necessarily preclude you from ever serving with children or youth.
Have you ever been concerned that you may have an addiction to drugs, alcohol, pornography or any other addiction; or has anyone ever suggested that you may have a problem with any of the above?
*
If yes, please explain
Have you ever been arrested, convicted or pleaded guilty to a crime?
*
If yes, please explain.
Have you ever been accused, charged, alleged to have or have you ever committed any act of neglecting, abusing, molesting or battering any child or adult?
*
If yes, please explain.
Have you ever been treated for a psychiatric disorder?
*
If yes, please explain.
Is there any circumstance or pattern in your life, which would make it inappropriate for you to serve with minors or would compromise the integrity of The Nathaniel Mission?
*
If yes, please explain.
References
List three (3) people that you know, who meet the following criteria: l) Are over 18 years old. 2) Are not related to you. 3) Have a definite knowledge of your character. 4) Have known you for more than 1 year. 5) Have seen you around/working with minors/kids.
Reference #1
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Association
*
Occupation
*
Length of time known
*
Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Reference #2
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Association
*
Occupation
*
Length of time known
*
Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Previous Address
If you have lived at your current address for less than five years, provide information on all addresses during that period.
Address #1
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address #2
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address #3
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Applicant's Statement
The information contained in this application is correct to the best of my knowledge. I authorize any references listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for working with children or students. I authorize the release of the information contained in this application, on a confidential, need to know basis, to any ministry at the Nathaniel Mission in which I seek a volunteer position. In consideration of the receipt and evaluation of this application by the Nathaniel Mission, I hereby release any individual, church, youth organization, charity, reference or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature, which may at any time result to me, my heirs or family, on account of compliance or any attempts to comply, with this authorization. To uphold the confidentiality of the references, I waive any right that I may have to inspect any information provided about me by any person or organization, but I may contact the Nathaniel Mission to inquire about information provided about me. Should my application be accepted, I agree to refrain from unscriptural conduct in my service on behalf of the Nathaniel Mission. Also, I hereby request and authorize the release of any information which pertains to any record of convictions contained in law enforcement files or in any criminal file maintained on me whether local, state or national. I give my permission to criminal records to be checked every three years, if I am still active in volunteering with children/youth. I hereby release local, state and national law enforcement agencies from any and all liability resulting from such disclosure.I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement, which I have read and understand.
Signature
*
Clear
If applicant is under 18 years old, a parent or guardian must sign. Parent/Guardian Signature:
Clear
Send
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform