Brady Lane Ministry Application
This application is to be completed by all applicants for any volunteer or teaching position within Brady Lane Church ministries.  This is not an employment application form.  
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Email *
Mark the area(s) you would like to serve in
Time *
Age Group *
General Information
Today's Date *
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Name *
Street Address *
City *
State *
Zip *
Home Phone *
Work Phone
Email Address *
Birthday *
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DD
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Do you regularly attend Brady Lane worship services? *
If yes, when did you start attending?  (approx. date)
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Ministry Information
Are you serving in another Brady Lane Ministry?  If so, please list: *
I have chosen to work with Children at Brady Lane because ... *
Have you personally and publicly accepted Jesus Christ as your Lord and Savior, been immersed, and are you committed to striving to display the character of Jesus through your life?       *
Are you currently a member of Brady Lane Church? *
References:  List 3 adults you have known for at least 2 years, who are not related to you who have specific knowledge of your character and ability to work with children and who fit the classifications set forth below.
1. Brady Lane (or previous Church) member or staff person:
Reference Name *
Reference Relationship *
Length of time known *
Reference Phone Number *
2. Employer or fellow employee:
Reference Name *
Reference Relationship *
Length of time known *
Reference Phone Number *
Previous Address:  If you have lived at your current address for less than 3 years, please list last address at which you lived.
Street Address
City
State
Zip
Dates from/to
Present Employer *
Street Address
City *
State *
Zip Code *
Job Title/Description
Personal Disclosure Information: Please choose appropriate response
1.  Do you have children? *
Names & ages of children
2.  Have you ever been arrested, convicted, or plead guilty to a crime? *
If yes to question #2, please explain
3.  Have you ever been charged or ever committed any act of abuse, or molestation of any child? *
4.  Have you ever been concerned that you may have an addiction to drugs, alcohol, pornography or any other addiction; or has anyone ever suggested that you may have a problem with any of the above? *
5.  Have you ever been convicted of the possession, use, or sale of drugs within the last 7 years? *
6.  Within the past 30 days have you abused alcohol, legal or illegal drugs? *
7.  Is there any fact, circumstances, or pattern involving your background that would make it inappropriate for you to serve with minors or would compromise the integrity of the church? *
If Yes to #7, please explain
Church History & Prior Children's/Youth Work
Previous church work involving children/Youth (list church name, city, state, and type of work performed) *
Previous non-church work involving children/Youth (list each organization name, city, state, and type of work performed) *
Applicant’s Statement:The information contained in this application is correct to the best of my knowledge.  I authorize any references, churches, or organizations listed in this application to give you any information (including opinions) that they have regarding my character and fitness for ministry.  I authorize the release of the information contained in this application to any individuals who make decisions about placing applicants in available positions.  In consideration of the receipt and evaluation of this application by Brady Lane Church, I hereby release Brady Lane and any individual, church, youth organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply, with this authorization.  I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application.  Should my application be accepted, I agree to conduct a Christ like/Biblical character both in the performance of my services on behalf of the church and in my personal life.  I also agree to uphold those beliefs in teaching and/or counseling of Brady Lane Church as prescribed in scriptures including but not limited to:
* Jesus is the Christ, Son of the Living God, who died of our sins & arose from the dead (1 Corinthians 15:1-8)
* The Bible is the inspired Word of God (2 Timothy 3:16)
* Every person has worth as a creation of God, but that "all have sinned and fallen short of the glory of God." (Romans 3:23)
* Everyone who accepts Christ as Lord & Savior should repent of sin, confess their faith and be baptized into him (Romans 10:9 & Acts 2:38)
* The church is the body of Christ on earth and exists to reach the lost and edify the saved (Ephesians 4:1-16)
* Jesus Christ will one day return to earth and reign forever as King of Kings and Lord of Lords (1 Thessalonians 4:13-18)
 I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND SIGN THIS RELEASE AS MY OWN FREE ACT.  This is a legally binding agreement that I have read and understand.
Applicant's Electronic Signature (Type full name) *
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