Little Disciples Interest Form
Full name (Last, First, Middle- please add full middle name)
Birthday
(Month/Day/Year)
If over 18, permission to run background check
Yes
No
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Cell Phone Number
-
Area Code
Phone Number
Social Security Number (Will be used for background check only)
T-Shirt Size:
Do you attend Mount Pleasant Christian Church?
Yes
No
If not, what church do you attend?
(Answer "None" if not applicable)
When are you available to serve?
Tuesday morning, 9:15-11:45am
Every other Thursday morning, 9:15-11:45am
All Thursday mornings, 9:15-11:45am
Both Tuesday and Thursday mornings, 9:15-11:45am
Will your own children be needing childcare?
Yes
No
If so, please list their names and ages below:
Please indicate what serving position in which you are most interested:
Lead Teacher (must be 18 years old and will have some light teaching responsibility)
Assistant Teacher
Substitute Teacher (to be placed on a call list for when classroom subs are needed)
Submit
Should be Empty: