NRCOC: River Kids Teaching Application

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This is an application to teach in the children's ministry at north river, and thank you for volunteering to serve in the Children’s Ministry! You only need to complete this form if you haven't taught at North River within the last couple of years. This information will be used for the purposes of protecting the children of our program. Our children’s safety is a top priority, and a thorough screening of all teachers and other Children’s Ministry volunteers is one important step we take to accomplish this goal. We’ll follow up after we have had a chance to review your completed form. If your application is approved, we will conduct a brief screening interview with you, at which point you may clarify or expound upon anything listed here.Thank you so much for your heart to serve God's church in this way, and we look forward to talking with you soon.

Personal Data

Please complete this section/portion every rotation!

What is your full legal name? *

Other names used

including nicknames, maiden names, other names you go by, etc.

What is your birth date? *

YYYY

What is your birth place city *

What is your current address? *

What is a current contact number for you? *

What is an email address you check frequently, in which we can contact you? *

Have you been a member at North River Church of Christ for six months or longer? *

yes

In what position do you anticipate serving in this rotation? *

Why do you want to serve the church family as a teacher? *

Have you ever been convicted of, pled guilty to, or pled no contest to a crime other than a minor traffic violation? *

yes

I'd like to discuss this privately

Required

If you answered yes, please explain below

Are you now under charges for any criminal offense? *

(This won’t necessarily disqualify you from serving)

If you answered yes to the previous question, please explain here

Is there anything in your past you think might disqualify you from volunteering in Children’s Ministry or having contact with children in the church? This includes acts of actual or alleged child abuse, or background of abuse . *

(having been abused won’t necessarily disqualify you from serving)

Work/Volunteer References: Please list at least two references from places of employment or prior volunteer service, especially regarding any work with other youth serving organizations. *

(please include start and end dates, work/position, reference name and reference contact information

Church References: Please list at least two North River Church of Christ member refrences that you are not related to. If you attended another church prior to North River Church of Christ, please list one refrence from your previous church. *

Please include member's full name, and email contact information.

Authorization and Release of Liability: please insert initials below if you agree *

I hereby authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children or youth work. In consideration of the receipt and evaluation of this application by the North River Church of Christ I hereby release 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 have read and agree to follow the youth ministry policies of the North River Church of Christ and to refrain from any illegal or unscriptural conduct in the performance of my services on behalf of the church. The information contained in this application is correct to the best of my knowledge, I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement, which I have read and understand.

Authorization and Request for criminal records verification and fingerprint information. Please initial below if you consent. *

I hereby authorize the North River Church of Christ to obtain and/or request information about my criminal history and fingerprints from any entity chosen specifically for conducting this search, to release information regarding any record of charges or convictions contained in its files, or in any criminal file maintained on me, whether said file is a local, state, or national file, and including but not limited to accusations and convictions for crimes committed against minors, to the fullest extent permitted by city, county, state, and federal law. I do release said entities from all liability that may result from any such disclosure made in response to this request. I may revoke this request at any time, but that revocation must be in writing and give 30 days' notice of same.

If you are a minor: please submit a minor form as soon as possible.

This form allows us to run a background check on you, and to complete a screening interview with you.

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