Complete Legal Name *
Email Address *
Cell Phone *
Cell Phone
Cell Phone Carrier *
Birthdate *
Birthdate
Place of Birth *
Current Occupation *
Social Security Number *
Driver's License Number *
Driver's License State of Issue *
Do you have any medical training or are you CPR certified? If yes, explain. *
Marital Status *
Single
Married
Divorced
Separated
Widowed
Name of Spouse
Number of Children
Ages of Children
Current Address *
Current Address
Previous Address
Previous Address
Years at this address
Do you have a personal relationship with Jesus Christ? *
Yes
No
Unsure
Briefly describe when and how you became a follower of Christ *
How long have you been attending Vineyard Church of Baton Rouge? *
Which Life Group?
What church (if any) did you previously attend (include city and state)?
What leadership / volunteer experience have you had with kids? List all previous work involving kids and youth.
List any skills, training, educations, or other factors that have prepared you to work with kids
Name *
Name
Phone Number *
Phone Number
What is your relationship with this person and how long have you known them? *
Address
Address
Name *
Name
Phone Number *
Phone Number
What is your relationship with this person and how long have you known them? *
Address
Address
Name *
Name
Phone Number *
Phone Number
What is your relationship with this person and how long have you known them? *
Address
Address
Why do you want to work with children at Vineyard Church of Baton Rouge? *
Do you have any preference concerning the age group or sex of children or students whom you would like to work? Why? *
What is your philosophy concerning re-direction or discipline of children? *
Have you ever physically or sexually abused a child? *
Has someone ever accused you of abusing a child? *
Do you or have you ever used, obtained, produced, or distributed child pornography? *
Do you participate in any activities that could reflect questionable on your moral character? If so, what are they? *
With whom do you live? What is your relationship with them? *
Have you had any painful experiences in your life that have better equipped you for--or may hinder you from working with kids? *
Would you like to meet with a pastor regarding these experiences?
If yes to any of the above, please explain.
The information contained in this application is true and correct to the best of my knowledge. By signing below, I authorize the Vineyard Kid's Director to make an independent investigation of my background, references, character, past employment, education, criminal or police records, including those by both public and private organizations, and all public records for the purpose of confirming the information contained on my application form, and/or obtaining other information which may be material to my qualifications for employment or as a volunteer now and during the tenure of my association with Vineyard Kid's Ministry. I release Vineyard Church of Baton Rouge and any person or entity that provides information pursuant to this authorization from any and all liabilities, claims, or lawsuits in regards to the information obtained from any and all of the above referenced sources used. *
Type you full name and the date as the signature.
