KidCare Adult Application
Thank you for your interest in helping with our KidCare Ministry! We look forward to coming alongside you through your application process.
* First Name
* Last Name
* Gender
Female
Male
* Birth Date
* Mobile Phone
* Email
* Address
Address 2 (Apt/Suite # etc.)
* City
* State/Province
* Zip/Postal Code
* How long have you attended Pathway?
* T-shirt size (Adult)
Select one
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large
Adult 4XL
Adult 5XL
* Are you applying for a volunteer position or a paid position?
Select one
Volunteer only
Paid only
Either
I'd like more information
* When would you like to serve?
Daytime Monday-Friday
Evening Monday-Friday
Weekend Events (outside of service times)
Personal Reference(s)
* Please list the name of someone who knows your character well. They must be 18 or older and not related to you.
* Personal Reference Email Address
* Personal Reference Phone Number (including area code)
* Second Personal Reference
* Second Personal Reference Email Address
* Second Personal Reference Phone (with area code)
Salvation Journey
* Have you made a personal decision to receive Jesus as your Lord and Savior?
Select one
Yes I have
No I have not
* Tell us briefly about your salvation story.
* Would you feel comfortable talking to a child about salvation and leading him/her to Jesus?
Select one
Yes
No
Maybe
* List all leadership/volunteer experience you have had with children
In caring for children at Pathway, we believe it is our responsibility to seek individuals who are able to provide healthy, safe and nurturing relationships. Please answer the following questions honestly. Please understand that the information provided in this application will remain confidential. Each question is required. Please type your answer in the box provided.
* Are you currently struggling with an addiction to drugs, alcohol, pornography or any other addiction? If yes, please explain
* Have you in your past ever struggled with an addiciton to drugs, alcohol, pornography or any other addiction? If yes, please explain
* Have you ever been arrested, convicted, or pleaded guilty to a crime more serious than a traffic violation? If yes, please explain
* Have you ever been accused of, charged with, alleged to have or have you ever committed an act of neglecting, abusing, molesting or battering any child or adult? Or have you had any kind of relationship with a minor that has brought you sexual gratification? If yes, please explain
* Have you ever been accused or convicted of possession and/or sale of controlled substances or of driving under the influence of alcohol or drugs? If yes, please explain
* Are you using illegal drugs?
Select one
Yes
No
* Have you ever gone through treatment for alcohol or drug abuse? If yes, please explain
* Have you ever been or are you currently being treated for a psychiatric disorder?
Select one
Yes
No
Signature and Acknowledgement
- The information contained in this application is correct to the best of my knowledge. I authorize any references listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children or youth work. I authorize the release of the information contained in this application, on a confidential, need to know basis, to any Ministry at Pathway Community Church in which I seek a position. In consideration of the receipt and evaluation of this application by Pathway Community Church, 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. To uphold the confidentiality of the references, I waive any right that I may have to inspect any information provided about me by any person or organization, but I may contact Pathway Community Church to inquire about information provided about me. Should my application be accepted, I agree to refrain from unscriptural conduct in the performance of my services on behalf of the Church. I agree to be bound by the by-laws, statement of faith and policies of Pathway Community Church. If I violate these guidelines, I understand that I have disqualified myself from any volunteer opportunities. By signing this application, I state that all of the information given about myself is true.
Release
- Also, I hereby request and authorize the release of any information which pertains to any record of convictions contained in law enforcement files or in any criminal file maintained on me whether local, state or national. I hereby release local, state and national law enforcement agencies from any and all liability resulting from such disclosure. I further state that I have carefully read the foregoing release and know the contents thereof and sign this release as my own free act. This is a legally binding agreement, which I have read and understand.
* Electronic Signature
* Today's date
By signing below, I give my consent to allow Pathway Community Church to use my likeness in printed and online materials:
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