Name
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First Name
Last Name
Email
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Address
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Mobile Phone
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Home Phone (if applicable)
(###)
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Best way to contact me
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Birthday
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MM
DD
YYYY
Marital Status
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Spouse's Name
First Name
Last Name
Children Name(s) and Ages
How long have. you attended New Covenant?
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Are you a member of New Covenant?
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Please describe your relationship with God.
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What are your spiritual gifts, strengths, talents and/or interests?
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In which ministry do you want to serve?
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Why do you want to work with children or youth at New Covenant?
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What previous or current experience do you have working with children and/or youth? What ages have you worked with?
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Do you have any additional training that we should know about (CPR, Trauma Response, Special Needs, etc).
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Have you ever been convicted of a criminal offense (felony or misdemeanor) involving moral turpitude or violence? (Crimes of moral turpitude involve fraud, theft or dishonesty.) Answer ‘yes’ if you have entered a plea agreement, including a deferred sentence or deferred judgment arrangement in connection with a criminal case. Answering ‘yes’ does not necessarily preclude an applicant from volunteering at New Covenant.
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Have you ever been charged with any felony or misdemeanor crimes for which you were not convicted?
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Are you presently under charges for any criminal offense?
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Have you ever been convicted for use or sale of drugs?
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Have you ever been charged with a sexual offense, offense relating to children, or crime of violence?
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Have you been arrested, for sexual assault or molestation related to a child or vulnerable adult
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Have you been reported to any organization or registry for abuse or misconduct involving children?
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Do you have any disciplinary action or investigation pending by an employer, other organization, professional association, or licensing body, for violence, sexual misconduct, or misconduct involving children or vulnerable adults?
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Have you ever been disciplined or dismissed from any volunteer or employment position following an allegation of sexual misconduct or physical aggression, verbal aggression, or other inappropriate behavior?
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Have you ever been reprimanded, or asked to leave or end your involvement/work in any program or organization providing services to children, youth or vulnerable adults?
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Do you now or have you ever sought out or intentionally viewed child pornography?
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Have you ever physically or sexually abused a child, youth or vulnerable adult?
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Has someone ever accused you of physically or sexually abusing or molesting a child, youth or vulnerable adult?
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Have you ever been the subject of an investigation or allegation of sexual misconduct, sexual abuse or sexual harassment involving a child or vulnerable adult?
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Have you ever been the subject of a civil lawsuit involving sexual misconduct or sexual abuse of a child, youth or vulnerable adult?
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Have you ever sought a Victim Protective Order or had one sought against you?
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Do you currently struggle with drugs, alcohol, pornography, or any other type of harmful addiction?
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Do you have any conditions, behaviors, traits, or tendencies that could pose a threat to others?
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Do you have any conditions or limitations preventing you from performing any activities relating to children’s work?
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Please give a full explanation of any question above answered ‘yes’.
Did you experience physical or sexual abuse as a child? We realize this information is sensitive, and it will be kept entirely confidential, except in circumstances where a child is in danger. You may choose to discuss your answer in confidence with one of the pastors. Answering ‘yes’ to this question will not preclude an applicant from volunteering.
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If yes, at what age did the abuse occur, and how long did it continue?
Have you had an opportunity to receive counseling and spiritual care in order to process the past abuse in a healthy manner? If so, when and how did this occur?
If you have not had the opportunity to receive counseling and spiritual care related to past abuse, would you consider counseling or other ministry resources to address any resulting emotional or spiritual harm?
Reference #1:
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First Name
Last Name
Email
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Phone
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(###)
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Relationship to Reference #1 and time known
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Reference #2:
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First Name
Last Name
Email
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Phone
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(###)
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Relationship to Reference #2 and time known
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Reference #3:
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First Name
Last Name
Email
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Phone
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(###)
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Relationship to Reference #3 and time known
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APPLICANT STATEMENT, PHOTO/VIDEO RELEASE, AND BACKGROUND CHECK
The information contained in this application is correct to the best of my knowledge. I authorize the release of the information on a confidential, need-to-know basis, to any ministry at New Covenant Church (New Cov) in which I seek a position (volunteer or compensated). I authorize any reference to provide any information (including opinions) that they may have regarding my character and fitness for any volunteer opportunity at New Cov. In consideration of the receipt and evaluation of this application by New Cov, I hereby release any individual, church, youth organization, charity, 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. As an active New Cov volunteer, I agree to refrain from unscriptural conduct in the performance of my services on behalf of New Covenant Church. I understand that, as a volunteer at New Cov, I am not covered by the church’s worker’s compensation insurance coverage in the unlikely event of any injury I may sustain while fulfilling my volunteer duties.
New Cov reserves the right to use any photograph/video taken at any event sponsored by New Covenant Church, without the expressed written permission of those included within the photograph/video. New Cov may use the photograph/video in publications or other media material produced, used or contracted by New Cov including but not limited to: brochures, invitations, books, newspapers, magazines, television, websites, etc. Any person desiring not to have their photo taken or distributed must contact the staff member coordinating the event.
I understand that upon completion of this application, I will be required to undergo a criminal background check. (Background check release information will be sent to me by New Cov ministry directors.)
Please take a moment to review these statements before electronically signing.
APPLICANT SIGNATURE (Full Name and Date)
