Ministry Safe Summer Adult Application
This application must be completed by all persons wanting to serve with minors or vulnerable adults.
Sender Name
Name
*
First Name
Middle Name
Last Name
Suffix
Date of Birth
*
/
Month
/
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone Carrier
Email
*
example@example.com
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Ministry Service Areas
Please indicate the environments you would be interested in serving in this summer.
*
Nursery (infant - 36 months)
Older Preschool (3 - 5 years)
Elementary
If you are willing to serve in more than one, please sort them from first choice at top to last choice at the bottom.
Please select which service(s) you are willing to serve during:
*
9:00 AM (Nursery and Welcome Team only)
10:45am
How many Sundays would you like to serve?
*
Please Select
All Sundays that I'm available.
1
2
3
4
5
6
7
8
9
10
11
12
13
Please select the Sundays you will NOT be available during the summer (^ = Sundays elementary will not meet or be a sermon release time):
*
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Background Information
Thank you for taking time to share with us about yourself. Please note the following information will be confidential. In caring for children, we believe it is our responsibility to seek an adult staff that is able to provide healthy, safe and nurturing relationships. Please answer the following questions. Answering yes to any of them does not automatically disqualify a person from serving.
Have you ever been charged with, found guilty or pleaded guilty or no contest to a crime other than minor traffic violations?
*
Yes
No
I would like to discuss my answer in person.
Have you ever been accused, investigated, charged, arrested or convicted of child abuse, sexual abuse or sexual assault?
*
Yes
No
I would like to discuss my answer in person.
Is there anything in your life now or from your past that may affect your ability to report observed, suspected or disclosed abuse situations?
*
Yes
No
I would like to discuss my answer in person.
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Personal References
Please list 2 personal references. People who can attest to your character and/or work with minors. Your reference may not be a relative or a Trinity Fellowship Pastor, or Trinity Fellowship Ministry Director.
Name of Personal Reference 1
*
Email for Personal Reference 1
*
example@example.com
Phone number for Personal Reference 1
*
Format: (000) 000-0000.
Name of Personal Reference 2
*
Email for Personal Reference 2
*
example@example.com
Phone Number for Personal Reference 2
*
Format: (000) 000-0000.
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Appliant's Statement
*
Signature
*
Submit
Should be Empty: