MOPS Kids Worker Application

1

We love MOPS Kids!

Our goal is to create a safe, nurturing environment for all children. We will engage with stories, songs, and age-appropriate play. Thank you for your interest in investing in the lives of moms by helping care for their little ones. Your answers to the following questions will be kept in strictest of confidence.

2

Which would you prefer:* This field is required.

I would like to serve as a volunteer and donate my time

I would like to serve as a paid worker and receive $12 per hour

3

Full Name* This field is required.

First Name

Last Name

4

Date of Birth* This field is required.

Date

5

Phone Number* This field is required.

Area Code

Phone Number

6

Email* This field is required.

7

Address* This field is required.

Street Address

Street Address Line 2

City

State

Zip Code

Country

8

Have you ever served in other MOPS Kids program?* This field is required.

YESNO

9

At which organization(s) did you serve?* This field is required.Please provide date(s).

10

Why do you want to serve in the MOPS Kids ministry?* This field is required.

11

Describe other experience or education that may have prepared you to work with MOPS Kids.* This field is required.

12

Have you been trained or certified in CPR?* This field is required.

YESNO

13

When were you trained/certified?* This field is required.

14

Which age group do you prefer to work with?* This field is required.Check all that apply

Babies

Age Two - Walkers

Age Three - Pre-K

15

Please describe any physical limitations or personal situations that would impact your work with the MOPS Kids program.* This field is required.

16

Home Church* This field is required.

South Valley Community Church

I do not have a home church

Other

17

Where you do you attend church?* This field is required.

18

How would you describe your relationship with Jesus?* This field is required.