* How long have you lived at this address? Select one More than one year Less than one year (please provide previous address)
* Preferred Contact Method Select one Phone Call Email Text
* Marital Status Select one Single Married Divorced Separated Widowed
* Number of Children and Ages
* Are you currently First Aid and CPR certified? Select one Yes No
* T-shirt size (Adult) Select one Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Adult XXX-Large
* Have you made a personal decision to receive Jesus as your Lord and Savior? Select one Yes I have No I have not
* Would you feel comfortable talking to a child about salvation and leading him/her to Jesus? Select one Yes No Maybe
* When and how did you come to know Jesus? What has your journey with Jesus been like?
* List all leadership/volunteer experience you have had with children
Personal Reference(s)
* Second Personal Reference Address
* Have you in your past ever struggled with an addiciton to drugs, alcohol, pornography or any other addiction? If yes, please explain
* Has anyone ever suggested to you that you may have an addiction 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
* Do you use illegal drugs? If yes, please explain
* Have you ever been or are you currently being treated for a psychiatric disorder? Select one Yes No
* If yes, what type of treatment did you receive or are you currently receiving?
* Is there any circumstance or pattern in your life which would make it inappropriate for you to serve with minors or would compromise the integrity of Pathway Community Church? If yes, please explain
* Have you ever been asked to step away from ministry or been asked to step down from working with students or children in any setting, paid or volunteer? If yes, please explain
PLEASE READ THE FOLLOWING CAREFULLY AND INDICATE YOUR CONSENT TO EACH ITEM BY TYPING YOUR INITIALS IN THE BOX PROVIDED - KidCity Volunteer Questionnaire
* I understand the expectations that Pathway Community Church and KidCity have of me as an Adult Volunteer and I am committed to doing my best to fulfill these expectations. Select one Yes No