VCCE Confidential Application for Childcare Work
This application is to be completed by all applicants for any paid 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.
Date *
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Name *
Your answer
Present Street Address *
Your answer
City *
Your answer
Zipcode *
Your answer
Cell Phone Number *
Your answer
Email Address *
Your answer
Are you 18 years of age or older? *
Are you eligible to work in the Unites State of America? *
For which Position are you applying? *
On what date will you be available?
MM
/
DD
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Can you commit to working for at least 1 year? *
Do you attend VCCE regularly? *
If No, do you attend another church regularly?
Have you ever been investigated, charged, or convicted of any crime, (i.e. felony or misdemeanor)? *
If Yes, Please Explain:
Your answer
Do you have any handicaps or conditions which would prevent you from performing certain types of physical activities? *
Were you a victim of abuse or molestation while a minor? (You may discuss your answer in confidence with the Childcare Coordinator rather than answering it on this form. Answering yes, or leaving the question unanswered, will not automatically disqualify an applicant for children or youth work).
Have you ever served in any of the Armed Forces?
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