Volunteer Application: Adult

* First Name

* Last Name

* Which ministry area are you currently volunteering in or would like to start volunteering?

* Birth Date

* Address

Address 2 (Apt/Suite # etc.)

* Mobile Phone

* Mobile Carrier

* Email

* Marital Status

Spouse's Name

Spouse's birthdate

Spouse's phone number (used in case of emergency)

Children's Name & Ages

Occupation

- Please provide your employment information below.

* Employer

* Work Phone

* May we contact you at work?

References

- Please list the names of three references who know your character well. They must be 18 years or older and NOT related to you. You must provide their full contact information.

* Reference #1 Name

* Relationship Reference #1

* Phone number Reference #1

* Email address Reference #1

* How long have you known this person? Reference #1

* Reference #2 Name

* Relationship Reference #2

* Phone number Reference #2

* Email address Reference #2

* How long have you known this person? Reference #2

* Reference #3 Name

* Relationship Reference #3

* Phone number Reference #3

* Email Address Reference #3

* How long have you known this person? Reference #3

Statement of Faith & Church Involvement

- Please answer the following questions completely.

* Have you made a personal decision to receive Jesus as your Lord & Savior?

* When and how did you come to know Jesus?

* What has your journey with Jesus been like?

* Do you consider Grace to be your home church?

If yes, how long have you attended?

If no, which church do you consider to be your home church, if any?

* Are you a:

* Are you a ministry partner?

* List all leadership/volunteer experience you have had:

* What gifts or training have contributed to your interest in serving at Grace?

Additional Information

- Please be assured that all answers are kept confidential. We are asking these questions in order to be in compliance with our liability insurance carrier and to do our due diligence in screening those who interact with our minor students. We are committed to ensuring a safe and secure environment for all ministries. Not all affirmative responses result in exclusion from volunteering, but "yes" responses indicate a need for us to talk further. Some yes responses eliminate applicants from assuming a position of influence with minors. Please note that Indiana is a mandatory reporting state, so we are required to report any abuse or neglect to DCS.

* Are you currently struggling with an addiction to drugs, alcohol, pornography or another addiction?

* Have you ever struggled with an addiction to drugs, alcohol, pornography, or any addiction?

* Has anyone ever suggested that you may have an addiction to the things previously listed?

* Do you use illegal drugs?

* Have you ever been arrested, convicted, or plead guilty to a crime other than a traffic violation.

* Have you ever been accused of, charged with, alleged to have, or have you ever committed an act of neglect, abuse, molesting, or battery?

* Have you had any kind of relationship with a minor that has brought you sexual gratification?

* Have you ever been accused or convicted of possession and/or sale of controlled substances?

* Have you ever been accused or convicted of driving under the influence of alcohol or drugs?

* Are you currently in a relationship with someone AND living together outside of marriage?

* Is there any circumstance or pattern in your life which would make it inappropriate for you to serve with minors?

* Is there any circumstance or pattern in your life that would compromise the integrity of Grace?

* Have you ever been asked to step down from working with minors in any setting, paid or volunteer?

If you answered YES to ANY of the above questions, please explain your answer below:

Grace Kids & Student Ministries Applicants ONLY:

- Grace Kids & Student Ministries Applicants ONLY:

Have you read our Child Protection Handbook?

Have you met with or will you meet with the Grace Kids Ministries Director or Student Ministries Pastor?

Statement of Agreeance:

- Please type your initials below each of the following statements to acknowledge you agree with the statements provided.

* 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 work with children or youth.

* I authorize the release of the information contained in this application on a confidential, need to know basis, to any ministry at Grace Church in which I seek a position.

* 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 attempts to comply with this authorization.

* I understand the expectations that Grace Church has of me as an Adult Volunteer and I am committed to doing my best to fulfill these expectations.