Children & Youth Ministry Volunteer Application Form

Children & Youth Ministry Volunteer Application Form

Thank you for offering to serve in this important ministry. As part of our plan to ensure the safety of children and youth within our church ministries, this application process is the required first step for all applicants in our screening and evaluation process. It is one important factor in helping us to effectively place screened, trained and qualified volunteers into positions of trust caring for our vulnerable attendees. Please answer all questions fully and truthfully.
Ministry/Department(s) you are applying to serve:*

Sunday School - Big City Avenue K-5Wee CollegeSunday School - One Way St. Pre-KGodZoneSunday Nursery - 3 mos - 36 mosBus DriverImpact Youth
Personal Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email (Please confirm your e-mail address in second box.)*

Confirmation Emailexample@example.com
Primary Phone Number*

Area CodePhone Number
Primary Phone*
Secondary Phone Number

Area CodePhone Number
Secondary Phone
Do we have your permission to text message you at your cell phone number?*

YesNo
Personal History
School/University, Occupation and/or Employer*
Hobbies, Interests or Skills*

Ministry Information

Churches attended in the last five years are as follows:
1. Name of Church*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates Attended*
Member or Adherent?*

MemberAdherent
2. Name of Church
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates Attended
Member or Adherent?

MemberAdherent
My present and previous ministry experience is as follows:
1. Name of Church / Organization
Dates and Description of Ministry
Pastor or Ministry Supervisor
Phone Number

Area CodePhone Number
2. Name of Church / Organization
Dates and Description of Ministry
Pastor or Ministry Supervisor
Phone Number

Area CodePhone Number

References

Please provide the names and complete contact information of three individuals, excluding relatives, who could provide a reference for you. Include at least one reference from outside the church. References will be contacted.
1. Name of Reference*

First NameLast Name
Nature of Relationship
Email
example@example.com
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2. Name of Reference*

First NameLast Name
Nature of Relationship
Email
example@example.com
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
3. Name of Reference*

First NameLast Name
Nature of Relationship
Email
example@example.com
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Release of Information and Declaration of Intent
I hereby give Calvary Temple Winnipeg Inc. permission to contact the persons named as references to ascertain my suitability for volunteer ministry. I release all such references from liability for any damage that may result from furnishing such evaluations to you.

I give Calvary Temple Winnipeg Inc. consent to verify the information provided herein and to contact the references listed. I waive any right to confidentiality and of any right to pursue damages against Calvary Temple Winnipeg Inc. for losses caused by the reference’s response.

I also grant my permission for Calvary Temple Winnipeg Inc. to perform a police records check, for purposes of my protection against any false allegations and for the protection of those I serve. I consent to such an investigation with the understanding that the results will be kept in strict
confidence. I agree to adhere to the protection policies as adopted by this Calvary Temple Winnipeg Inc..

I understand that if my character or morals are deemed by Calvary Temple Winnipeg Inc. leadership to be inappropriate and/or criminal at any time during my volunteer service, Calvary Temple Winnipeg Inc. will be entitled to terminate my assistance without express cause or prior notice regardless of any other oral or written statement by Calvary Temple Winnipeg Inc. prior to,
at, or following the date of volunteer service.

I understand that Calvary Temple Winnipeg Inc. is responsible for the welfare of any person or persons entrusted to my care. I will cooperate fully with the staff in the fulfillment of my duties and will keep all information I encounter, in my role as a volunteer, confidential. If at any time I find that for any reason I am unable to support the policies, procedures or doctrine of Calvary Temple Winnipeg Inc., I will gracefully and quietly resign my volunteer position. If my supervisors find that I am in conflict with any of the policies, procedures or doctrines and we are not able to resolve the issue, I will gracefully and quietly agree to resign my volunteer position.

I hereby acknowledge that, to the best of my knowledge, the information contained in this application for volunteer ministry is true and correct. I accept and agree to adhere to the Statement of Faith of Calvary Temple Winnipeg Inc..
Name of Applicant*

First NameLast Name
Using your mouse on a computer, or your finger on a touch screen, please sign on the line below.

Clear
Today's Date*

MonthDayYear
Date
Information received is confidential and is being gathered for the purposes of screening Program Personnel and placing them into ministry with Children and Youth. The information gathered here will be used for the purposes of supporting the ministries at Calvary Temple Winnipeg Inc..

Calvary Temple Winnipeg Inc. Confidentiality Agreement
I understand that I may obtain, become aware of or have access to sensitive and confidential information in my role as an employee / volunteer with Calvary Temple Winnipeg Inc. That confidential information may include, without restriction, personal information regarding employees, volunteers, members, attendees, supporters or persons assisted by Calvary Temple Winnipeg Inc. including information in relation to donations, personal or family matters, or obtained from background screening of prospective employees or volunteers. I agree to maintain strict confidentiality of all such confidential information and I will not disclose such information to anyone (including to employees, volunteers, members, attendees, supporters, persons assisted, or my spouse or family members) except authorized representatives of Calvary Temple Winnipeg Inc. who need to know such information or as required by law. I understand and agree that confidentiality is very important in my role and critical to the effective functioning of Calvary Temple Winnipeg Inc. If I become aware that any confidential information was improperly disclosed, I will immediately advise Lead Pastor of Calvary Temple Winnipeg Inc.
Name of Applicant*

First NameLast Name
Using your mouse on a computer, or your finger on a touch screen, please sign on the line below.

Clear
Today's Date*

MonthDayYear
Date

Calvary Temple Winnipeg Inc. | Plan to Protect® Policy
This policy has been adapted from Plan to Protect®, permission granted by Plan to Protect® 2015© for use by Calvary Temple Winnipeg Inc..
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Children & Youth Ministry Volunteer Application Form

Personal Information

Personal History

Spiritual History

Ministry Information

Confidential Information

References

Release of Information and Declaration of Intent

Calvary Temple Winnipeg Inc. Confidentiality Agreement