This application is to be completed by all Children’s Ministries staff and volunteers. It is one part of our effort to provide a safe and secure environment for the children who attend our ministries and programs

This application is to be completed by all Children’s Ministries staff and volunteers. It is one part of our effort to provide a safe and secure environment for the children who attend our ministries and programs. All information will be kept confidential, stored in a secured location, and used only by the leadership of Fremont Presbyterian Church. Thanks for your time and interest in working with children.

Fremont Presbyterian Church

Children’s Ministries Volunteer Application

Personal Information
Name ___________________________________________ Date of Birth _________________________
Place of Birth ___________________________ Social Security # ________________________________
Address ______________________________ City ____________________ Zip ____________________
Home Phone __________________________ Work ________________Cell___________________
Email ________________________ Driver’s License Number _____________________ State_____
Occupation ________________________________ Employer __________________________________
Married □ Single □ Spouse Name:____________________ Children (names & ages) ____________­
____________________________________________________________________________________
Do you have any physical limitations or conditions that would prevent you from performing certain activities or duties pertaining to your area of ministry? Yes ____ No ____

If yes, please explain ___________________________________________________________

Do you have personal health and/or accident insurance? Yes _____ No _____ If no, please note that by signing this application you are agreeing to the following statement:

The applicant understands that Fremont Presbyterian Church (FPC) provides liability coverage for most church-sponsored events. The insurance is secondary to one’s own insurance coverage, which is agreed as being primary. In the event a volunteer is injured and is not personally insured, the volunteer agrees to cover the deductible rate costs required by FPC’s insurance carrier.

For Administrative Use Only

 Reference  ________ date

 Background  ________ date
□ Fingerprinted ________ date ______B


Form Updated 4/13/16


Spiritual History
Briefly explain when and how you became a Christian.
____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________
Please list your last place of worship (these will be used as references - if you attended for less than 3 years, please list two churches if possible).
Church ________________________________ Pastor _____________________ Phone _____________
Address ______________________________________ City/State ________________ Zip ___________
Church ________________________________ Pastor _____________________ Phone _____________
Address ______________________________________ City/State ________________ Zip ___________
What were the circumstances or reasons leading to your leaving these churches? ___________________
____________________________________________________________________________________
Were you involved in any ministries at these churches? ________________________________________
____________________________________________________________________________________
History at FPC
Are you a member of FPC? yes / no Regular attendee? yes / no
When did you begin attending (month and year)? ________________________
What are you doing to grow in your faith at this present time (Small group, Bible Study, etc.)? ________
___________________________________________________________________________________
Are there any other church ministries and activities in which you are currently involved? ____________
____________________________________________________________________________________
Are there any ministries and activities you were involved in, but aren’t anymore? ___________________
____________________________________________________________________________________

Children’s Ministries Gifts and Experience
Special gifts and talents (storytelling, music, puppets, drama, crafts, etc.) __________________________

____________________________________________________________________________________

____________________________________________________________________________________
Age group with which you are most comfortable ______________________________________________
Special training, classes, seminars, or conferences you’ve attended related to children’s ministries (any
ministry, profession, parenting classes, or whatever applies)____________________________________
____________________________________________________________________________________
Describe any experience you’ve had working with children or youth in a church setting. _______________

____________________________________________________________________________________

Describe any experience you’ve had working with children or youth in a community setting (Girl Scouts,
coaching, teaching, etc.) ________________________________________________________________

How do you spend your leisure time? ______________________________________________________

Position Desired and Length of Commitment
Position desired ______________________________________________________________________
Age Group/Grade Level ________________________________________________________________
 Sunday School KIDS Church  Mid-week  Nursery
 Special Events  Office Support  Preschool  Elementary

I have prayerfully considered working in Children’s Ministries in the above position. Realizing the importance to the children to maintain continuity and security in their lives, I am committing myself for a period of _______________ (months/years) from _____________ to _____________. At the end of this time, I will re-evaluate and pray to determine further commitment.

Personal Info & References
List two references (NOT RELATIVES) that can testify to your personal character and dependability. Remember that all personal information gathered will be strictly confidential, accessible to church leadership only, and kept in a secure place. Please have at least one be an attendee of FPC.
1) Name ________________________________________________ Phone __________________
Address ____________________________________ City, State, Zip ______________________
Email ___________________ Relationship _______________Years Acquainted _____________
2) Name ________________________________________________ Phone __________________
Address ____________________________________ City, State, Zip ______________________
Email ____________________Relationship _______________Years Acquainted _____________
If you have prior experience in ministry or with children, please list two references that have supervised you or worked with you:
1) Name ________________________________________________ Phone __________________
Address ____________________________________ City, State, Zip ______________________
Email ______________Relationship ______________Years Acquainted ____________________
2) Name ________________________________________________ Phone __________________
Address ____________________________________ City, State, Zip ______________________
Email _______________Relationship _____________Years Acquainted ____________________
Please answer the following and be assured that a “yes” answer will not necessarily disqualify you from being a Children’s Ministries volunteer. If you answer “yes” to any of the following questions, please explain on a separate sheet of paper.
1) Have you even been denied the opportunity to work with children at any Yes _____ No _____

other church, institution, or any other setting?

2) Have you ever been under discipline at any church or ministry, or under investigation by any

business or organization? Yes _____ No _____

3) Have you ever been convicted of neglecting, abusing, Yes _____ No ____

or molesting any child?

4) Have you ever been convicted of using or selling drugs? Yes _____ No _____
5) Have you ever been hospitalized for alcohol or substance abuse? Yes _____ No _____
6) Has your driver’s license ever been suspended or revoked? Yes _____ No _____
7) Have you ever been treated for a psychiatric disorder? Yes _____ No _____
If you responded yes to any of the above questions, please use an additional sheet of paper to explain.

I give permission to run a criminal background check. ______ (please initial) You may make a donation toward fingerprinting and background check costs if you choose.

List of Commitments
I understand that while involved in Children’s Ministries at FPC, I am making a commitment to the following responsibilities:
I will maintain my personal relationship with Jesus Christ through devotional Bible reading and fellowship with other Christians, and will live my life in accordance with God’s Word.
I will attend Sunday morning worship regularly.
I will pray regularly for the children for whom I am responsible.
I will cooperate in a spirit of unity and loving support with my Children’s Ministries Director, other support staff, and volunteers.
I will arrive at my place of ministry on time and well prepared, striving to present God’s Word clearly and accurately to the children to whom I minister to a safe and fun environment.
I will make every effort to attend all teacher meetings and enrichment classes offered.
The information contained in this application is correct to the best of my knowledge and I will do my best to fulfill the above expectations. I authorize any references, churches, or institutions listed in this application, including any law enforcement or government agencies, to give FPC any information regarding my character, background, and fitness for Children’s Ministries. I release such references from liability for any damage that may result from furnishing information to FPC.
Signature __________________________________________ Date _________________________

For Office Use Only
Interviewed by _____________________________________________________________________
Comments ________________________________________________________________________
References checked by ______________________________________________________________
Reference :________________________________________________ Date ___________________
Comments: _______________________________________________________________________
Reference :________________________________________________ Date ___________________
Comments: _______________________________________________________________________
Reference :________________________________________________ Date ___________________
Comments: _______________________________________________________________________
Approval for Ministry
_________________________________________________________ Date ____________________

Director of Children’s Ministries


If you have questions regarding any part of this application, please contact Tyler Withers, the Minister to Children and Families at [phone] x 222 or [e-mail].