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VOLUNTEER APPLICATION for CIC KIDS, christianinternationalchurch.org
CIC KIDS VOLUNTEER APPLICATION SERVICE -99 Two Bridges Road , Lincoln Park, NJ 07035 Phone: 973-633-9090
VOLUNTEERING for *
Required
Name: *
Last
First name *
middle name
If you have ever used any other name(s), please provide in full
Address *
Street/ City/ State/ Zip Code
Telephone/Celluar numbers *
Home / Work / Cell
PARENT/GUARDIAN if you are under 18 years of age/Telephone/Celluar numbers *
Home / Work / Cell
Email(s) *
Preferred email: / 2nd email
Email(s) *
Preferred email: / 2nd email
Date of Birth *
Marital status -If married, spouse’s name *
On what date would you be available to serve *
The following questions are used to help our church provide a safe, loving, and secure environment for the children who participate in our programs. If you prefer not to answer any of these questions in writing, you may leave them blank and a staff member, youth worker, or elder will talk with you personally and privately. Your answers in this application will not necessarily disqualify you for children & youth work, although if they raise a concern which leads us to believe that an issue needs to be addressed further with you in a private meeting to learn whether the issue has a bearing on your ability to work with children or youth. *
Please list all churches you have regularly attended during the past five years (use the space below if more space is needed): Name of Church\ City and State\ Pastor\ Dates Attended\
*
I give permission for Church to contact previous church?
*
I give permission for my child to serve in CIC KIDS (grade 6 -12) under 18 yrs of age
Please list all churches you have regularly attended during the past five years (use the space below if more space is needed)
Describe all previous work, paid or volunteer, in this church or elsewhere, involving children or youth. Please give dates, names of churches or organizations, and types of work.
Describe any gifts, training, education, or other factors that qualify you to work with youth *
Have you ever been convicted of a criminal offense (felony or misdemeanor, except for minor traffic violations)? *
Have you ever been charged with a sexual offense, offense relating to children, or crime of violence? *
Have you ever been reported to a social service agency, law enforcement authority, child abuse registry, or similar organization regarding abuse or misconduct involving children? *
Have you ever been subjected to expulsion, discharge, reprimand, or other disciplinary action by a church, denomination, religious organization, or employer? *
Have you ever been the subject of any disciplinary action, transfer, or dismissal, or been named as a defendant in a civil or criminal lawsuit, as a result of an accident or mishap involving children? *
If you answered “yes” to any above, the Lead Pastor/church Leadership member will meet with you to discuss the situation in private. *
Please briefly explain when Jesus Christ became your Savior and Lord. *
What do you do on a daily and/or weekly basis to strengthen your relationship with Jesus Christ? *
After reading the CIC Statement of Faith. Do you agree with, accept and believe the principles and beliefs set forth in the Statement of Faith? *
Are you currently a member of our Church- CIC? *
If you answered yes above, please indicate date and year of membership *
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I affirm that the answers and information I have provided on this application form are true to the best of my knowledge. I understand and agree that, if I obtain a volunteer position with Christian International Church, and if I have provided inaccurate information on this application form, or at any other step in the application process, this may result in discharge from service. I understand and agree that any volunteer position I may have at CIC is a volunteer position, and that I have no expectation of pay, compensation, or benefits of any kind, or an expectation of future employment, in exchange for such volunteer services. I understand and agree that my volunteer service is at will. This means that CIC is free to terminate my service at any time, with or without advance notice, and for any reason, and that I am free to resign from service at any time, with or without advance notice, and for any reason. I authorize CIC to review my background information document sent from fingerprinting agency. I specifically authorize CIC, as it deems appropriate, to contact all references, churches, organizations and persons identified by me. I authorize all such persons or organizations to release to CIC any information they may have regarding my record and character for working with children/youth. I give permission to CIC to conduct a name/criminal background investigation concerning me, again, as Christian International Church deems appropriate. I hereby give permission to CIC and its directors, employees, agents, and representatives, to fully review any and all claims that might arise from reviewing and processing my application as well as my background investigations. Federal law, under the federal Fair Labor Standards Act, (FLSA) defines individuals that provide services without any expectation of compensation, and without any coercion or intimidation, as “volunteers” (non-employees). *
I agree that Volunteers act as a ministry working together to obtain the services of those who wish to give of themselves through selfless actions without reimbursement. *
Signature *
electronic signature
Should my application for children/youth work be accepted, I agree to be bound by the By-Laws of Christian International Church and its policies for children/youth workers. I also agree to refrain from any unscriptural conduct in the performance of my services on behalf of the Church. *
Print Name *
Signature of Applicant *
electronic signature
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If you are currently employed in any capacity in a public/private school, and have been fingerprinted, please provide us with a copy of the paperwork, so that we can attach this to our records. Also, please send any current CPR, CPS, EPI Pen or any other medical certification that you may have to this application. *
Please get fingerprinting for background check from NJ local IdentoGO and list CIC as one of the agencies to receive the report. Thank you. *
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