New Hope Children's Ministry Screening Form
First Name *
Your answer
Last Name *
Your answer
DOB *
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Address *
Your answer
City/State/Zip *
Your answer
Phone Number *
Your answer
Member *
How long have you attended New Hope? *
Your answer
Have you ever worked with children before, if so in what capacity? *
Your answer
What are you volunteering for? *
Your answer
Name and Phone number of someone who has known you well for at least 5 years and can recommend you for ministry. *
Your answer
Name and Phone number of someone who has known you well for at least 5 years and can recommend you for ministry. *
Your answer
The following will be kept confidential:
Have you ever been accused of or prosecuted for any abuse or sexual misconduct with a child or adult? *
If yes, are you willing to meet with someone regarding the situation?
Is there anything about you we need to know about? (Health, past, etc.) *
If yes, please explain.
Your answer
Share briefly about how you came to Christ. *
Your answer
Typing your name here indicates a desire to serve in this ministry and a willingness to follow our policies and guidelines. *
Your answer
Criminal History Authorization
In order to protect the children, we require every new volunteer to undergo a criminal history background check. Information provided by this check will not necessarily disqualify a candidate from serving; however, the prospective volunteer will not be allowed to serve until the background check is completed. All information will be kept confidential.
The information on this form will be used to complete the criminal history background check, and will be retained in your application file. (After we use your social security number we will black out the number).
Criminal history and reference checks along with the application will be held at the church office in a locked file. Any applicant with a criminal history containing offenses other than traffic related offenses will be contacted by the administrator before approval. Any applicant with a criminal history containing any kind of sex offense and who has been prosecuted for said offense will not be allowed to serve in the program. All criminal history reports containing offenses other than traffic related will be kept in a separate locked file in a location separate from the rest of the applications. You may request a copy of your criminal history report. If you believe your report is in error, you may attest the record. No decision will be made until the outcome of the attesting is received.
By typing my name below, I hereby authorize First Advantage to release any information which pertains to any record of conviction in its files or in any criminal file maintained on me whether local, state or federal. I hereby release First Advantage and New Hope Community Church from any liability resulting form such a disclosure.
I understand that I may obtain a copy of the Criminal History Report and will be given the opportunity to challenge the accuracy and completeness of this report and obtain a prompt determination as to the validity of the challenge before a final determination is made by New Hope Community Church.
Full Name (First, Middle, Last) *
Your answer
Maiden name, if applicable
Your answer
Social Security Number *
Your answer
Date of Birth *
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Current Address *
Your answer
City/State/Zip *
Your answer
Today's Date *
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YYYY
Signature - Typing your name is your signature for this form *
Your answer
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