Teen Volunteer Application | Bethesda Community Church

This application is for all teens, 13 through 17 years of age after at least 6 months of active involvement at the church, for any position involving the supervision of children. This is not an employment application. The purpose is to assist in the creation of a safe environment for children who participate in the programs of Bethesda Community Church or use Bethesda Community Church, School, or Daycare facilities.

Name*

First Name

Middle Name

Last Name

Address*

City

State/Province

Zip/Postal

Home Phone

Cell Phone

Email*

Date of Birth*

Gender*

Male

Female

Are you a regular attendee of this church?*

Yes

No

If so, how long?

List all previous paid or volunteer work involving children. This would include all church and non-church paid or volunteer work with children. (List each church or organization's name and address, type of paid or volunteer work carried out, dates, and a contact person familiar with your work there.)

Previous Paid or Volunteer Work:

List talents, preparation, training or other experiences which have equipped you to work with children:

Because our church cares for our members and children, and desires to protect them, please answer the following questions. We understand that the answers to these questions may be private and deeply personal, and we will protect your privacy.

Why do you want to work with children at Bethesda Community Church?*

Do you have a preference concerning the age group or gender of children or students with whom you would like to work?*

Yes

No

If yes, please explain:

What is your philosophy concerning re-direction or discipline of children?*

When you are unhappy, angry or emotional about a person or circumstance, what do you do?*

Have you experienced any significant physical or emotional stresses within the past year, such as the loss of a parent, extreme ill health, or any emotional or physical crisis?*

Yes

No

If yes, please explain:

Do you consider yourself to have been physically or sexually abused in the past? (This information will be kept entirely confidential.)*

Yes

No

If yes, please explain:

If you were physically or sexually abused in the past, we want you to know that Bethesda Community Church has counseling and resources available to you. Would you consider utilizing church resources to receive help in this area of your life?

Yes

No

If yes, please explain:

Have you ever physically or sexually abused a child?*

Yes

No

If yes, please explain:

Has someone ever accused you of abusing a child?*

Yes

No

If yes, please explain:

Please provide adult references. Include one work or volunteer reference (if available) and one personal reference. References must include at least one non-family member and one member of the opposite sex. Give complete mailing addresses, including zip codes and email addresses. Please contact your references and tell them an authorized Bethesda Community Church staff person will be contacting them to complete the application process.

References (Friend of family, teacher, coach, neighbor, or employer)*

Include Name, Address, and Phone Number.

References (Friend of family, teacher, coach, neighbor, or employer)*

Include Name, Address, and Phone Number.

RELEASE

VOLUNTEER SIGNATURE

I authorize Bethesda Community Church to contact all individuals, organizations, and references listed on this Teen Volunteer Application Form in order to verify the information I have provided to the church. I agree to release from liability any person or organization that provides information concerning me, including those persons I have listed as references, as well as contact persons from my previous volunteer or paid work. By signing this form, I certify and affirm that the information I have given on this form is true, complete and correct in all respects.*

Please Type Your Name as Your Signature

Date*

PARENT SIGNATURE

I have reviewed this application with my child and I believe all the information provided is true, correct and complete. I am unaware of any fact or circumstance involving my child that would call into question the wisdom of entrusting my child with the supervision, guidance or care of younger children. To my knowledge, my child has never abused a younger child.*

Please Type Your Name as Your Signature

Date*