Children's Ministry Special Events Application

Thank you for your interest in serving in our Children’s Ministry Special Event at Otterbein. I believe you are going to be blessed not only by the children you will be working with but also by the other volunteers you’ll have the opportunity to serve alongside. For the safety of our children and as a part of our screening process, all children’s ministry volunteers must have had a security clearance check within the past five years. That’s why we’ll be asking for your Social Security number and date of birth. Please take the time to complete the form and make sure you click on the SUBMIT button at the bottom. Please email or call me if you have any questions. Thanks!

Amanda Myers, Otterbein Church Children’s Ministry Director amanda.myers@otterbeinchurch.org 717.762.7147 x231
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Phone*
Please enter a valid phone number.
Home Phone
Please enter a valid phone number.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
How long have you attended Otterbein?*

Less than 6 months6 months-1 year1-2 years2-5 years5-10 yearsmore than 10 years
During which event are you signing up to serve?*
Have you ever been accused or convicted of any form of child abuse?*

YesNo
Authorization & Release

The information provided in this application is correct to the best of my knowledge. I understand this information will be kept confidential by the professional church staff.I give Otterbein Church permission to complete a background check on my behalf. I acknowledge that I have never been convicted of child abuse or a crime involving any child. I agree to be bound by the discipline and policy procedures of Otterbein Church.
Digital Signature*

Clear
Social Security Number (only numbers, no dashes)*
Should be Empty:

Authorization & Release