L4JVolunteer – Good Shepherd

Because Good Shepherd cares for our members and our 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. For any “yes” answers, please attach a detailed explanation in writing.

Have you ever been convicted of a criminal offense (felony or misdemeanor)? Answer “yes” if you have entered a plea agreement including a deferred sentence or deferred judgment arrangement in connection with a criminal case.

Have you ever been charged with a sexual offense, offense relating to children, or crime of violence?

Have you ever physically, sexually or emotionally abused a child?

Do you have any disciplinary action or investigation pending by an employer, other organization, professional association, or licensing body, for violence, sexual misconduct, or misconduct involving children?

Have you ever been disciplined or dismissed from any volunteer or employment position for any reason or following an allegation of sexual misconduct, physical aggression, verbal aggression, or other inappropriate behavior or conduct?

Have you ever been reprimanded, or asked to leave or end your membership in a church?

Have you ever been the subject of a complaint or disciplinary proceeding concerning any professional license or professional affiliation held by you?

Do you now or have you ever sought out or intentionally viewed child pornography?

What service are you available to serve in?

Sunday 1st (8:30am) Sunday 2nd (10:15am)

Which age groups are you interested in? (please pick top 3)

Have you personally accepted Jesus Christ as your Lord and Savior?

Are you committed to having the character of Jesus live through you?

Describe other ministries that you lead or serve in, how often, and will you continue if also serving in Children’s Ministry?

Why do you feel called to serve in Children’s Ministry?

If known, please list your spiritual gifts, talents or abilities:

Describe all knowledge, training or experience working with children (previous and current).

Please provide contact information for a single individual, who have known you for at least 1 year, and who have a definite knowledge of your character, personality, and abilities. The Good Shepherd Children’s Director will call your references to confirm your credibility. Please inform all references that they will be contacted by Good Shepherd Children’s Ministry, prior to returning this application for review.

Volunteer Statements and Agreed Code of Conduct

I declare that all statements contained in my Application are true. I understand that any misrepresentation or omission is cause for dismissal from any ministry involvement.

Yes

I agree to provide additional references and contacts from prior church or non-church work with children or students, upon request, and that an appropriate criminal and sex-offender registry background check will be conducted. I authorize investigations of all statements contained in this application. I specifically authorize the church to undertake a criminal background check of my past.

Yes

I understand that I must be interviewed and recommended by a member of the Good Shepherd Children’s Ministry Screening and Selection Committee before I begin service as a volunteer in the Good Shepherd Children’s ministry.

Yes

I understand that I must complete a Child Abuse Awarness Training video as part of my application process before serving with children.

Yes

I understand that I can withdraw from the application process at any time.

Yes

I understand that Good Shepherd has a policy of ZERO TOLERANCE FOR ABUSE and takes all allegations of abuse seriously. I further understand that Good Shepherd cooperates fully with the authorities to investigate all cases of alleged abuse. Abuse of any kind is grounds for immediate dismissal from my volunteer position and possible criminal charges.

Yes

I declare that I am not a pedophile or child molester. I have not perpetrated physical abuse, sexual abuse, emotional abuse or neglect against a child or student, and I have never been accused of these acts.

Yes

I understand and agree that false statements regarding past conduct and/or present situations may be grounds for denial of this application to provide volunteer services, and that refusal to inform Good Shepherd of the contents of a sealed criminal record will result in the automatic denial of the application.

Yes

If accepted as a volunteer, I agree to abide by all Policies and Procedures provided to me by Good Shepherd Children’s Ministry

Yes

I authorize any references or churches listed in this application, to give you any information (including opinions) that they regarding my character for working with children.

Yes

I authorize the release of the information contained in this application to any other ministry at Good Shepherd in which I seek to serve.

Yes

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