Primary phone number:*
Date of Birth:*
Experience working with children: *
List any gifts, training, education, etc. that have prepared you to work with children. *
I am interested in (check all that apply): *
How long have you attended FBC?*
Are you a member of FBC?*
What other ministries are you involved in at FBC?*
Please write a brief testimony as to when and how you came to know Jesus Christ as your Lord and Savior. *
Please write a brief description of your relationship with Christ today. *
References: Please provide two references who are familiar with your character, preferable as it relates to working with children. References must be at least 18 years old and unrelated to you.
How long has this person known you and in what capacity?*
How long has this person known you and in what capacity?
Personal Background: The questions listed below are necessary in order to provide a safe and secure environment for our children. If the answer is yes to any of these questions, please explain. All information will be held strictly confidential. Thank you for your cooperation and understanding.
Have you ever been convicted of a crime (other than minor traffic violations) or a serious juvenile offense?*
Have you ever been charged with neglect or abuse of a child/youth?*
In the past five years, have you, or anyone you know, been concerned that you were addicted to alcohol?*
In the past five years have you used or sold illegal drugs?*
In the past five years have you, or anyone that you know, been concerned that you were addicted to pornography?*
Has your driver's license ever been suspended or revoked?*
Other than the matters asked about above, is there any circumstance involving you or your background that would call into question your being entrusted with the supervision, guidance, and/or care of children or would compromise the integrity of this church?*
If you answered 'Yes' to any of the above questions, please identify the question number and state any pertinent information below.
I understand and agree to the following:
The information I have provided may be verified by contacting the persons named in this application. I consent to a background check. If questions arise concerning my fitness for duty, I will be notified of its nature by the Children's Pastor. I hereby release from liability of any kind and agree to hold harmless any person or organization that provides information on my background to FBC and its agents. I also release from liability of any kind and agree to hold harmless Fellowship Bible Church, Winchester VA and the elders, pastors, employees, volunteers and agents thereof.
I agree to regularly attend worship service at Fellowship Bible Church.*
I agree to teach/lead under the authority and direction of the Elder Board and the Children's Ministry Leadership Team.*
The personal information I have provided will be restricted to the Elders and Pastors of Fellowship Bible Church. I affirm that the information I have given is true and correct.