Community Church Security Volunteer Application
Dear Potential Security Volunteer,
Community Church welcomes your interest in serving God through working in our security ministry. As you can imagine, keeping Community Church a “safe place”, is a top priority. Therefore we must find out more about the people to whom we are entrusting this security with. We understand that this application is long and quite personal; however, you can be assured that the staff of Community will hold all information confidential. Upon receipt of this application, we will let you know when you can begin serving.
We look forward to receiving your completed application. If you have any questions or concerns, please call Terry Sullivan at the church office (357-3360).
VOLUNTEER GENERAL INFORMATION
Date:________________________
Name:________________________________________
Address:______________________________________
How long have you lived in North Carolina?__________________
Home Phone:_____________________________
Work Phone:______________________________
Cell Phone:_______________________________
Email Address:_________________________________________
Are you: ____Single ____Married ____Separated
____Divorced ____Widowed
Spouse's name:________________________________________
How long have you attended Community Church?_____________
Do you attend: ___Weekend services ____Wednesday services
Are you involved in a small group or Bible study?________
Background Information
Have you ever worked in this type of ministry before?________
If yes, where?________________________________________
Have you ever had or been concerned that you might have an addiction to drugs, alcohol, pornography, or other addiction that might hinder your abilities as a security person? ___No
___Yes, explain:_______________________________________
_____________________________________________________
_____________________________________________________
Have you ever been arrested, convicted of, or pleaded guilty to a crime? ___No
___Yes, explain:________________________________________
______________________________________________________
______________________________________________________
Have you ever been accused, charged, or alleged to have committed any act of neglecting, abusing, molesting, or battering any child or adult? ___No ___Yes, explain:_______________________________________________
______________________________________________________
_______________________________________________________
Have you ever been treated for a psychiatric disorder? ___No
___Yes, explain:________________________________________
______________________________________________________
______________________________________________________
Is there any circumstance in your life that would make it inappropriate for you to serve with minors or that would compromise the integrity of Community Church?___________________________________________
____________________________________________________
REFERENCES
1)Name:_____________________________________________
Relationship to you:____________________________________
Length of time known:__________________________________
Home Phone:________________Work Phone:_______________
2)Name:_____________________________________________
Relationship to you:____________________________________
Length of time known:__________________________________
Home Phone:________________Work Phone:_______________
3)Name:_____________________________________________
Relationship to you:____________________________________
Length of time known:__________________________________
Home Phone:________________Work Phone:_______________
Service time(s) you are available to serve (please circle)
9am 11am Wednesday evenings
Applicant’s Statement:
All information contained in this application is true and correct to the best of my knowledge. I understand that staff at Community Church will contact my references and I authorize those references to give any information they may have regarding my character and ability to work with minors. I release all persons or organizations from any liability for damages resulting from such disclosures. I also authorize the release of any information pertaining to records of convictions contained in law enforcement or criminal files. I release all local, state, and national agencies from liabilities as well.
Should I undertake the position of a security volunteer at Community Church, I agree to refrain from unscriptural conduct in the performance of any duties on behalf of the Church.
Finally, I state that I have carefully read the above statement and understand it. I also understand that it is a legally binding agreement.
Print Full Legal Name:____________________________________
Driver’s License Number & State: _________________________
Social Security Number:_________________________________
Date of Birth:__________________________________________
Place of Birth:_________________________________________
Former addresses (over the last 10 years___________________
_____________________________________________________
Applicant’s Signature: _______________________________________Date______________
Parent/Guardian Signature: ___________________________________Date______________
(if applicant is a minor)
Please mail this application to: Terry Sullivan
2003 Cotton Grove Rd.
Lexington, NC 27292
You may also seal the application in an envelope directed to the attention of The Vineyard and drop in an offering bag, or give to one of the volunteers at the Vineyard table in Connections.
We look forward to having you join our ministry team!
