Zoe Volunteer Screening Form

Volunteer Screening Form

Zoe Community Church has contracted the services of a third party to run background checks on all volunteers working with children or vulnerable people. A national criminal records search is performed. The following information is required for this check. If you require more space, please attach an additional sheet.
What ministry are you applying to serve in?*

Zoe Kids on SundaysZoe Moms Midweek MinistryZoe YouthZoe College MinistryInternational Student OutreachOther
Part 1: Criminal Background Check
Name*

First NameMiddle NameLast Name
Please provide any additional names you have used, including a maiden name if applicable
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Social Security Number*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Zip Code
Criminal background check reports are confidential and viewed only by Zoe Community Church’s elders and filed in the applicant’s secure file. Any reported misdemeanor or felony will be discussed with you and an elder of the church, and may be grounds for denial of application to work with minors.

Personal information is protected under the Privacy Act. Reports obtained from protectymyministry.com will be guarded accordingly.
Consent to Criminal Background Check
I consent to a criminal background check conducted by Ministry Safe. I understand that any criminal history may prevent me from serving in the children's ministry at the discretion of the elders.*

YesNo

Part 2: Personal Background Check
Have you regularly attended another church in the past 5 years?*
Please provide the name and city of your previous church
Please provide two non-family references, preferably believers. At least one reference should be an attendee at Zoe Community Church.
Please provide one non-family personal reference. This reference should be a current member of Zoe Community Church.
Personal Reference #1*
Please provide a name, how you know this person, and a best method of contact, either phone number or email or both.
Personal Reference #2 - Preferably Zoe Community Church Member
Please provide their name and a best method of contact, either phone number or email or both.
For the safety of our church, all personal references will be contacted, as well as relevant organizations.
Please describe relevant childcare experience here
Will you need to bring a child with you to Zoe Moms childcare?*

YesNo
Please let us know the age and name of your child, as well as any special needs your child may have
Consent to Personal Background Check
The information provided above is true and correct to the best of my knowledge. I authorize Zoe Community Church to contact any references or organizations listed in this application, and authorize such references and organizations to provide Zoe Community Church with any information they may have regarding my character or fitness for working with children. I release Zoe Community Church, its agents, and all such references and organizations from any and all liability for any damages that may result from furnishing such evaluations to you, and I waive any right that I may have to inspect references provided on my behalf.*

YesNo

Thanks for completing our volunteer screening form! We will conduct a background check, contact your personal references, and communicate with you regarding any sensitive information.

By signing below, you affirm the truthfulness of this form and consent to a criminal and personal background check that may affect your ability to volunteer with Zoe Community Church.
Signature of Volunteer*
Should be Empty:

Volunteer Screening Form

Part 1: Criminal Background Check

Consent to Criminal Background Check

Part 2: Personal Background Check

Consent to Personal Background Check

Part 3: Sensitive Information