Application for Student Ministry

Catawba Valley Baptist Church

Children/Student Ministry Volunteer Application
Applicant Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
In which children's/youth program(s) do you want to become involved? (please check all the apply)

NurseryChildren's Church (2.5-3rd grade)AWANA (Age 3-5th grade)CVBC Students (6th grade-12th grade
What skills would you bring to the children's/youth program?
WHAT OTHER CHILDREN'S/YOUTH WORK EXPERIENCE DO YOU HAVE? (Please give the organization, program (children's church, child care, youth group, etc), how long did you volunteer/work, and a contact)
HAVE YOU AT ANY TIME EVER:
Been convicted of, or pleaded guilty or no contest to, any crime?

YesNo
Participated in, or been accused, convicted, or pleaded guilty or no contest to abuse or any sexual misconduct?

YesNo
ARE YOU AWARE OF:
Having any traits or tendencies that could pose any threat to children, youth, or others?

YesNo
Any reason why you should not work with children, youth, or others?

YesNo
If the answer to any of these questions is "yes" please explain in detail below.
CHURCH ACTIVITY

What church or churches have you attended in the past five years?
Church name, Pastor's name, Years attended:
SUPPLY AT LEAST TWO INDEPENDENT REFERENCES

Not relatives. Past ministry leaders or former employers preferred.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
CHILDREN'S/YOUTH WORK VERIFICATION AND RELEASE
I recognize that Catawba Valley Baptist Church is relying on the accuracy of the information I provide on the Children/ Student Ministry Volunteer Application form.

Accordingly, I attest and affirm that the information I have provided is absolutely true and correct.
I authorize Catawba Valley Baptist Church to contact any person or entity listed on the Children/Student Ministry Volunteer Application form, and I further authorize any such person or entity to provide the organization with information, opinions, and impressions relating to my background or qualifications.

I voluntarily release Catawba Valley Baptist Church and any such person or entity listed on the Children/Student Ministry Volunteer Application form from liability involving the communication of information relating to my background or qualifications.

I have carefully read the Children and Student Ministries Policies and Procedures of Catawba Valley Baptist Church, and I agree to abide by them and to protect the health and safety of the children or youth assigned to my care or supervision at all times.
Name

First NameLast Name
Date

MonthDayYear
Date
Signature

Clear
Minor Applicants

Parent Affirmation and Consent
I affirm that I am the Parent/Legal Guardian of the applicant. I recognize that Catawba Valley Baptist Church is relying on the accuracy of the information provided. To the best of my knowledge, I affirm and attest that the information provided is true and correct. I further attest and affirm that I am aware of no traits or tendencies of my child that could pose any threat to children, youth, or others.
Name

First NameLast Name
Date

MonthDayYear
Date
Signature

Clear
Should be Empty:

Catawba Valley Baptist Church

Applicant Information

HAVE YOU AT ANY TIME EVER:

ARE YOU AWARE OF:

CHURCH ACTIVITY

SUPPLY AT LEAST TWO INDEPENDENT REFERENCES

CHILDREN'S/YOUTH WORK VERIFICATION AND RELEASE

Minor Applicants