MSBC CHILD & YOUTH WORKER APPLICATION BACKGROUND AUTHORIZATION

CONFIDENTIALITY PLEDGE: All information gathered on this form will be kept in a secure location in the main office of the church and will be viewed by church leadership and staff to whom this information is pertinent.
Main Street Baptist Church is committed to providing a safe and secure environment for all children, youth, and volunteers who participate in ministries and activities sponsored by the church. The following policy statements and background check authorization reflect our congregation’s commitment to preserving this church as a place of safety and protection for all who would enter and as a place in which all people can experience the love of God through appropriate relationships with others.
This application is to be completed by all applicants for any position involving the supervision or custody of minors. This is not an employment application form. It is being used to provide a safe and secure environment for those children and youth who participate in our programs and use our facilities.
Please read our Child/Youth Protection Policy located on our website by clicking this link.
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GENERAL INFORMATION
 
 
 
 
 
 
 
 
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CHURCH AFFILIATION AND STATEMENT OF FAITH
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The doctrinal statement can be found on our website:
www.msbchurch.org/about/beliefs
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REFERENCES
List below two adults (who are not related to you) who have a definite knowledge of your character and ability to work with children.
Church staff member, leadership team member, small group or ministry leader:
 
 
 
 
 
 
 
Social friend, neighbor, or employer
 
 
 
 
 
 
 
PERSONAL SITUATION
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APPLICANT'S STATEMENT

The information in this application is correct to the best of my knowledge.  I authorize any references listed in this application to give you any information (including opinions) that they have regarding my character and fitness for children or youth work.  I authorize the release of information (which will be shared only with an appropriate staff member) contained in this application to any ministry at Main Street Baptist Church in which I seek a position.  In consideration of the receipt and evaluation of this application by Main Street Baptist Church, I hereby waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application.


I agree to abide by biblical principles while performing my serivces on behalf of the church.


I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND SIGN THIS RELEASE AS MY OWN FREE ACT.  This is a legally binding agreement in which I have read and understood.

 
BACKGROUND CHECK AUTHORIZATION

I hereby authorize Main Street Baptist Church and its designated representatives to conduct a criminal background check whether said file is local, state or national.  I further authorize the references listed on this application to give information regarding my character and fitness for ministry work with children.

 
PARTICIPATION COVENANT

      1.   An applicant who has been convicted of child abuse of any kind will not be permitted to work with children or youth in any church-sponsored activity.


      2.   Volunteers working with children and youth will observe the “Two Person Rule”.


      3.  Volunteers working with children and youth will annually review this policy and keep current with procedures and state laws regarding protecting against and reporting child abuse.


      4.   Volunteers will immediately report to their supervisor any behavior that seems abusive or inappropriate.

I have read this Participation Covenant, and agree to abide by the policies set forth above.
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ELECTRONIC SIGNATURE*
*By entering my name in the box below and submitting this form, I am electronically signing my name on this form.
 
 

Description

CONFIDENTIALITY PLEDGE: All information gathered on this form will be kept in a secure location in the main office of the church and will be viewed by church leadership and staff to whom this information is pertinent.
Main Street Baptist Church is committed to providing a safe and secure environment for all children, youth, and volunteers who participate in ministries and activities sponsored by the church. The following policy statements and background check authorization reflect our congregation’s commitment to preserving this church as a place of safety and protection for all who would enter and as a place in which all people can experience the love of God through appropriate relationships with others.
This application is to be completed by all applicants for any position involving the supervision or custody of minors. This is not an employment application form. It is being used to provide a safe and secure environment for those children and youth who participate in our programs and use our facilities.