Children's Ministry Application

First Name:    
Middle Name:
Last Name:    

Date of Birth:  

Current Address:
Street: 
City:     
State:  
Zip:      

Membership Status:
Attend LaGrange Baptist Church Regularly:
Moving toward membership:
Member of LaGrange Baptist Church:  
    (Approx. Month/YR):
 

 

General Information:
1. Briefly describe your testimony, how and when you became a Christian.

2. Describe an area in your life in which you are growing in spiritual maturity.

3. Please describe previous experience, paid or volunteer, in this church or elsewhere, involving children and their families.

4. Please describe any gifts, training, education, or other factors that would apply to your ministry to children and families.

5. What motivates you to become involved with ministry to children and families?

6. Name any other ministries you have served or are currently serving at LaGrange Baptist Church.

 

Personal Information:
What is your present occupation?
What is your family status? 
    Single   Married   Divorced   Widowed   Children

 

Security Issues:
In order to insure a safe and secure environment for the children who participate in our programs, we need the following information. If you prefer, you may discuss your answers with a staff member. Remember, all information will be kept strictly confidential. Answering yes to any question will not automatically disqualify you from children’s work.
 

Have you ever been convicted of or pleaded guilty to a crime?  Yes No
If yes, please explain.

Have you ever been a victim of abuse? Yes No

Have you, within the last two years, consistently and deliberately, viewed pornography? (i.e. internet, video, magazines, etc.)   Yes No

(If you prefer, you may discuss your answer in confidence with one of the ministerial staff, rather than answering on this form. Answering “yes” to these questions or leaving them unanswered will not automatically disqualify you.)

Applicants who have been members of LaGrange Baptist Church for one year of more may list their two references as the pastor or church leader and someone else within the congregation who knows them well and can attest to their suitability to work with children.

Reference 1:
Name:    
Address:
Phone:   
Relation:

Reference 2:
Name:    
Address:
Phone:   
Relation:

The information contained in this application is true and correct to the best of my knowledge. I authorize you to contact any references or organizations listed in this application and authorize such references / organizations to give you any information they may have regarding my character and fitness for working with children. I release LaGrange Baptist Church, all of its agents, and all such references and organizations from any and all liability for any damage that may result from furnishing such evaluations to you, and I waive any right that I may have to inspect references provided on my behalf.

I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW AND UNDERSTAND THE CONTENTS THEREOF. I SIGN THIS RELEASE ON MY OWN FREE WILL.

This is a legally binding agreement that I have read and understand.

Further, I affirm that I have neither been convicted of, nor pleaded guilty to, nor am I a subject of pending charges, for any crime or misdemeanor involving actual or attempted child abuse or neglect or sexual assault, failing to secure medical attention for an injured child, pandering, crimes against nature involving children, taking indecent liberties with children, neglect of children, obscenity offenses, or similar moral impropriety involving children in the Commonwealth of Kentucky or in any other jurisdiction. I recognize that, as part of my participation in child care ministry, I may be required to consent to and furnish to LaGrange Baptist Church a criminal conviction records check and consent to do so realizing the importance of promoting LaGrange Baptist Church’s ability to protect those under its care.

Electronic Signature:
I understand that by completing and submitting this form that I am in effect signing this document and dating it based on the system date stamp upon submittal. Yes No

Commitment:
In dependence on the Holy Spirit and by God’s grace –
  I will be faithful and dependable in this ministry.
  I will seek to learn more about ministering to children as information
         and training is available.
  I will commit myself to continuing personal spiritual growth.
  I commit to follow the policies set forth by the Preschool / Children’s
         Department of LaGrange Baptist Church.