FAC Kids Volunteer Application

Personal Information

Full Legal Name (First Middle Last)

Name You Use on a Day-to-Day Basis

Please Provide Any Nicknames or Aliases You Have Used To Identify Yourself Publicly (If None, please respond "N/A")

Maiden Name & Dates Used (If None, please respond "N/A")

Date of Birth

Current Address (Including City, State, and Zip)

Social Security Number (This is necessary for your background check, if you prefer us to call you to obtain this information, please respond "Contact Me")

Primary Phone Number

This address will receive a confirmation email

Marital Status

Single Married Divorced Seperated Widowed

If Married, Spouse's Name

Do You Have Any Children Attending FAC? If So, Please Provide Their Name(s) and Age(s)

Your Occupation

Spiritual/Ministry Information

Please tell us how and when you accepted Jesus Christ as your personal Savior and share any other relevant highlights of your spiritual journey.

Are you a member of FAC? If not would you be open to becoming one?

I am a member I am not a member, but I am interested in / open to becoming a member of FAC I am not a member of FAC and am not interested in / open to becoming a member at this time

If you have attended FAC for less than a year, please provide the name and address of your last church and the Pastor's name

Provide the names of two adults (not related to you) at FAC who know you fairly well

Have you ever worked/volunteered with children previously? If so, please share with us in what capacity you served, what age group/gender did you work with, and when/where this occurred

Please share with us any education or training you have obtained that is specific to children

How do you believe God has equipped you to work with children?

Which age group(s) are you interested in working with? (Check all that apply)

Nursery (0-2 years) Preschool (3 - 4 years) Early Elementary (K - 2nd Grade) Later Elementary (3rd - 5th Grade)

As an FAC Kids volunteer, how would explain the gospel to a child?

Is there any additional information you would like to share for us to consider?

FAC holds to the Scriptural teaching that the only proper sexual relationship is that within the bonds of marriage between a man and a woman. In your role as an FAC Kids Volunteer, do you agree to teach and lead children in accordance to these beliefs?

Yes No I would like to have a follow up conversation about this

Are you currently living in accordance with these beliefs?

Yes No I would prefer to have a follow up discussion about this

References

In addition to the people you mentioned earlier (those at church who know you well), FAC may find it necessary to ask for additional references, particularly if you have not been at the church very long. We will contact you if this is the case.

Thank you for your patience and understanding in this matter.

Background Check Information

In connection with your application to volunteer with FAC Kids, your submission of this form gives FAC permission to conduct a background check, including a criminal database search in each county/state where you have lived and worked, as well as contacts with references/past employers. The purpose of the background check is to gather sufficient information to make a suitability determination concerning your character, reputation, personal characteristics, and mode of living as it relates to the role of Christian leadership and fellowship within the FAC Kids ministry.

Information obtained during the background check will not be released to anyone other than a designated person at FAC whose duties/responsibilities require him/her to review such.

Information obtained on you will be protected in a secured container within the FAC Administrative Offices. The FAC Senior Pastor and/or his designee(s) will strictly control access to this container, the information within it, and protect it from unauthorized access/use.

Driver's license number:

Issuing state

Date issued

Expiration date

Are you interested in driving FAC vehicles to off-site FAC Kids activities

Yes No

Please list addresses where you have lived for the past 10 years beginning with your most current address.

Address 1

Address 2

Address 3

Address 4

Have you ever been (Check all that apply)

Arrested Convicted of or pleaded guilty to a criminal offense (include traffic offenses) Arrested or convicted of a sexual offense Required to report to an agency because of abuse or misconduct with regard to a child The subject of a complaint or disciplinary proceeding regarding a state issued license The subject of any disciplinary action as a result of an accident or mishap involving a child The subject of an action/proceeding by any organization, board, agency, department, or employer that resulted in adisciplinary action, suspension, or dismissal None of the Above Apply to Me

If you answered yes to any of the above statements, please provide the following information for each incident. • Date(s) incident(s) occurred. • Explain the incidents). What was the disposition of the incidents)? • State if you have been sentenced to or served any jail/prison/probation or community service as a result of the incident • In what city, county, and state the incident(s) occurred

Do you have (check all that apply)

Any ongoing serious medical condition or infectious disease that could endanger another person or negatively affect your ability to care for and safely interact with children? Any mental or physical condition that requires accommodation or special consideration so you do not injure yourself or others? A history of substance abuse or addiction or are you currently using addictive substances? None of the Above Apply to Me

If you answered yes to any of the above questions and would like to volunteer information for us to consider, please provide that information here.

Applicant's Certification and Consent

I certify all the information provided in this application is true and accurate to the best of my knowledge and I agree to keep First Alliance Church (FAC) advised of any changes to the information contained in my application.

I voluntarily waive all recourse and release FAC from all liability in connection with this Background Check. I agree that submission of this form will be considered effective and valid as an original.

By Submitting this Application form...

I authorize and request all individuals listed in my application to fully cooperate with FAC in this background check.

I also authorize and request all court systems, investigative agencies, and law enforcement agencies to release any information pertinent to me to FAC without restriction or qualification, including the release of a copy of my motor vehicle records.

I agree to the above statement in its entirety and certify my consent to all it contains.

Yes No

FAC Kids Volunteer Application

Description

Please Fix the Following