Adult Volunteer Application

Volunteer Application Form - Adult (over 18 years of age)

Please fill out the form below to apply for volunteering at our church. Thank you!

Contact Information

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Birthday *

Gender *

Male Female

Please list all current and previous church and community volunteer work. *

Profession/previous work experience. *

How long have you attended Plymouth Alliance Church? *

Where did you previously attend before Plymouth Alliance Church? *

What led you to apply? *

YOUR PERSONAL RELATIONSHIP WITH JESUS CHRIST

Check one of the boxes below that best describe your relationship with Jesus Christ. *

I have a relationship & I am assured of my salvation I think I have a relationship but am unsure of my salvation. I am still seeking a relationship with Jesus Christ. Other

Spiritual Journey

Your life before Christ. *

When did you accept the Lord as your personal Savior? *

How did you come to know Christ? *

Your life after you received Christ. *

CONFIDENTIAL SECTION

THE REMAINDER OF THIS APPLICATION IS CONSIDERED STRICTLY CONFIDENTIAL. IT WILL BE VIEWED AND USED ONLY BY THE PLYMOUTH ALLIANCE CHURCH STAFF MEMBER WHO ARE INVOLVED IN MAKING VOLUNTEER PLACEMENT DECISIONS. ALL COMPLETED MINISTRY APPLICATIONS ARE KEPT CONFIDENTIAL AND STAY IN A PASSWORD AND/OR LOCKED FILE IN THE CHURCH OFFICE AREA. IF YOU PREFER, YOU MAY CHOOSE NOT TO ANSWER THE QUESTIONS IN THIS SECTION OR YOU MAY DISCUSS YOUR ANSWERS IN CONFIDENCE WITH A PLYMOUTH ALLIANCE STAFF MEMBER. LEAVING ANY QUESTIONS UNANSWERED WILL INDICATE THAT A STAFF MEMBER WILL NEED TO CONTACT YOU FOR A FOLLOW UP.

Have you ever been charged, arrested, or convicted of any crime other than minor traffic violations? *

Yes No

If you answered "Yes," please explain. *

Have you ever been accused, investigated, charged, or convicted of child abuse, sexual abuse, or sexual assault? *

Yes No

If you answered "Yes," please explain. *

Were you a victim of abuse or molestation while a minor? *

Yes No

If you answered "Yes," have you ever received professional counseling? *

Yes NO

Have you ever been exposed to an incident of child abuse or neglect? *

Yes No

If you answered "Yes" please explain. *

How do you (or did you) discipline your own children? *

Have you ever participated in any form of pornography (magazines, internet, 900 number, etc)? *

Yes No

If you answered "Yes" please explain. *

Do you have any other history that may be of concern? If so, explain. *

I am free from any diseases that could be detrimental to children such as typhoid, paratyphoid, hepatitis, or other diseases. *

Yes No

REFERENCES

PLEASE LIST 3 REFERENCES WITH CURRENT EMAIL. IF YOUR REFERENCE DOES NOT HAVE EMAIL, THEN PLEASE PROVIDE A COMPLETE ADDRESS.
REFERENCES NEED TO BE FAMILIAR WITH YOUR CHARACTER ESPECIALLY AS IT RELATES TO WORKING WITH CHILDREN.
REFERENCES MAY NOT BE RELATIVES OR PAC STAFF.

Reference 1 *

Reference 2 *

Reference 3 *

BACKGROUND CHECK

WE CANNOT RUN A BACKGROUND CHECK WITHOUT YOUR BIRTH DATE, SOCIAL SECURITY # AND EMAIL ADDRESS. WE MAKE EVERY EFFORT TO SAFEGUARD YOUR INFORMATION. HOWEVER, IF YOU DO NOT WISH TO PROVIDE THAT INFORMATION IN THIS METHOD YOU MAY CALL THE CHURCH OFFICE DURING REGULAR BUSINESS HOURS AT 920-893-5525 AND ASK TO SPEAK WITH THE PERSON WHO DOES THE BACKGROUND CHECKS.

BY PROVIDING THE INFORMATION REQUESTED AND ELECTRONICALLY SIGNING YOUR NAME, YOUR ARE STATING THAT:
I AGREE TO A CRIMINAL BACKGROUND CHECK TO BE RUN ON MY NAME. I HEREBY REQUEST AND AUTHORIZE INFORMATION WHICH PERTAINS TO ANY RECORD OF CONVICTIONS CONTAINED IN THE FILES OR IN ANY CRIMINAL FILE MAINTAINED ON ME WHETHER LOCAL, STATE, OR NATIONAL. I HEREBY RELEASE LOCAL, STATE, OR NATIONAL LAW ENFORCEMENT AGENCIES FROM ANY AND ALL LIABILITY RESULTING FROM SUCH DISCLOSURE.

Response to disclosure statement. *

Yes No

Birthdate *

Social Security Number *

STANDARDS AND AGREEMENTS

Please read the attached Standards and Agreements. Then check the appropriate boxes below and electronically sign. When you sign below you are also signing on the following:
I have read, understand and agree to abide by the "Proper Behavior for Children's Ministry Workers" Policy, which refers to children and youth under 18 years of age and developmentally disabled persons of any age. Should my application be accepted, I agree to be actively involved in the ministries of this church, abide by the constitution and by-laws and policies of Plymouth Alliance Church and refrain from un-scriptural behavior in my ministry on behalf of the church.
I understand that the information I have provided may be verified, if necessary, by contacting persons or organizations named in this application, or by contacting any person or organization that may have information concerning me. I hereby release and agree to hold harmless, from liability, any person or organization that provides information. I also agree to hold harmless the organization, the officer, employees and volunteers thereof.
I further acknowledge that I have carefully read the foregoing release and know the contents thereof. I sign this release of my own free will. This is a legally binding agreement which I have read and understand. I promise I have answered all of the questions honestly to the best of my knowledge.

I wish to be held accountable as I serve at Plymouth Alliance Church's Children's Ministries as written in the Standards of Excellence *

Yes No

Please review our Statement of Faith.

I agree with the Statement of Faith: *

Yes No

Electronic Signature

Please type your name and date. This will serve as your electronic signature. *

Submit