Appendix 4 Application Package

Appendix 4: Child and Youth Volunteer Application Package (last revised November 2024)
Name

First NameLast Name
Address

Address

Street Address Line 2

City TownState / Province

Postal / Zip Code
Postal Code
Telephone
Email
example@example.com
I am aware that prior to working with children or youth at Grace Bible Chapel that I must observe a six month waiting period starting with the date I became actively involved with the meetings and programs of Grace Bible Chapel. I agree to attend at the Timmins Police Service or other (acceptable to the Elders) law enforcement agency and apply for criminal record checks consisting of a Police Criminal Record Check and a Police Vulnerable Sector Check. I understand that expenses incurred providing the proper criminal record checks will be reimbursed by Grace Bible Chapel upon the submission to the Coordinator of an official receipt(s
Signature of Applicant

Clear
Date

MonthDayYear
Date
Section 3:

As an applicant who has less than five years of active involvement at Grace Bible Chapel, please submit the names and contact information of two references from your former church, if applicable, for the purpose of obtaining two character references. (If no church was attended, two character references are still required from two credible sources who can attest to your character particularly in situations that involve children and youth if possible.)
Phone Number of Church
Name of Church
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact 1 Name
Phone Numbers
Contact 2 Name
Phone Numbers
The applicant the Grace Bible Chapel Prevention and Reporting of Child Abuse Training Module.
The applicant has successfully completed the Grace Bible Chapel Prevention and Reporting of Child Abuse Training Module
Signature of Coordinator

Clear
Date

MonthDayYear
Date
Section 5:The applicant who is new to Grace Bible has observed the six month waiting period prior to being authorized to volunteer in a program or programs with children and youth.
Name of Applicant
Name of Coordinator Please Print
Signature of Coordinator

Clear
Date

MonthDayYear
Date
The applicant has provided criminal record checks and has been interviewed by at least two elders or designates following the checking of at least two references for those new to Grace Bible Chapel The applicant as of date is now authorized to volunteer in a program or programs for children and youth

MonthDayYear
Date
Name of Elder 1 Please Print
Name of Elder 2 Please Print
Should be Empty: