FIRSTBAPTISTCHURCH OF GENEVA
APPLICATION FOR PAID CHILD CARE
**Confidential**
This application is to be completed by all applicants for any compensated position involving the supervision or custody of minors. It is being used to help the church provide a safe and secure environment for those children and youth who participate in our programs and use our facilities.
PERSONAL (Please Print)
Name (full, including middle name)______Date Application Completed______Maiden name (if applicable)______Social Security No.: ______
Address______City______State _____ Zip ______
Home Phone: ______Cell Phone: ______
E-mail address: ______
Name of church you attend? ______
How often to you attend church? Weekly Twice a Month Once a Month Less Than Once a Month
List any training, education, experience or other factors that have prepared you for working with children:
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HEALTH, SAFETY, & SECURITY: In order to assure the health, safety, and security of our children, we screen our volunteers. If any of the following situations apply to you, please check below so we may discuss how this may impact your work with children.
Have you ever tested positive for HIV or TB?
Have you ever abused drugs or alcohol, or had a problem with other addictions, such as pornography?
Have you ever been convicted of a felony or misdemeanor?
Have you ever been convicted or accused of physical abuse, sexual abuse, neglect, molestation, or exploitation of a minor?
Recognizing that abuse is a traumatic event in a person's life, and realizing that by God's grace a victim can find healing, if you are a victim of abuse who has not worked through your pain, the ministry staff is here to assist you. Please feel free to call.
PERSONAL REFERENCES (no relatives, please) People who have seen you work with children/youth would be great.
Name _____ Name ______
Address _____ Address______
City ____ State Zip City __ State Zip ______Telephone ____ Telephone ______
Nature of Association ___ _Nature of Association ______
E-mail ______E-mail ______
AUTHENTICITY AND AUTHORIZATION
I 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 working with children. I release all such references from any liability for furnishing such evaluations to you. I waive any right that I may have to inspect references provided on my behalf.
I have read the First Baptist Church of Geneva’s Protection Policy and agree to abide by it. Employment is contingent on the successful completion of a background check.
The information included in this profile is correct to the best of my knowledge.
Signature Date
Please complete the Statement of Faith on the next page.
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STATEMENT OF FAITH
Please give a brief testimony of your Christian experience including when and how you became a Christian. Also, please include how you maintain a close relationship with Christ.
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Do you believe that Jesus is the Christ, the Son of the Living God? ______
Do you believe that the Bible is the holy Word of God, written under the inspiration of the Holy Spirit, and that it has supreme authority in all matters of faith and practice? ______
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NameDate
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Print Name
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