Antioch Kid’s Ministry Volunteer Application Antioch Kids Ministry Volunteer Application We like to think of our volunteers as “Pillars.” We are always on the look-out for dedicated, caring and fun people to serve in Kids Ministry. Whether it’s with babies or elementary-aged kids, opportunities are everywhere to serve as a Pillar and impact the life of kids! Application Process: 1. Fill out this form completely. 2. When we receive your application, we will run a background check, contact references and set up a time for you to meet briefly with one of our kids pastors, so he or she can get to know you a little better, as well as share some vision and practicals and confirm your serving time and area. 1 General Information2 Volunteer Opportunities3 Legal Questionnaire4 Criminal Records Check Authorization5 Personal References6 Welcome Back!7 Acknowledgements Application Date* Date Format: MM slash DD slash YYYY ArchiveNoGeneral InformationThe information contained in this application will be kept confidential and only disclosed to those who have a genuine need to know in order to carry out their responsibility for/in Antioch Community Church, or as required by law. The purpose of obtaining this information is to protect both our workers and kids.Your Name* First Last NicknameAge*Applicants 12 years old or younger are required to have a parent or legal guardian present to fill out this form.* There is a parent or legal guardian present. Gender*MaleFemaleBirthday* MM DD YYYY Please indicate which grade best describes you.*Middle SchoolerHigh SchoolerPhone*Student Email (if applicable) Parent Email* Your Email* Place of Employment*How long have you attended Antioch?*Do you currently attend a Lifegroup?*YesNoLifegroup Leader's Name* First Last Lifegroup Leader's Phone*Lifegroup Leader's Email* Who is your current Spiritual Leader?Spiritual Leader Name* First Last Spiritual Leader Phone*Spiritual Leader Email* Volunteer HistoryPlease indicate which best describes your volunteer history:*I am a new Kids Ministry volunteer.I am a returning Kids Ministry volunteer, but I haven't served in the last 18 months.I've served in Antioch Kids Ministry in the last 18 Months.Though prior experience is not required, do you have any prior experience working with kids?*NoYesWhat experience do you have working with kids?*Why do you want to serve in the Antioch Kids Ministry?*Tell us about your relationship with Jesus.*Have you ever stuggled with respecting or obeying authority figures?*Is there an area in your life in which you are currently struggling?* Volunteer OpportunitiesPlease select where you would like to serve: Antioch Kids Ministry* Infants/Toddlers (Babies-2 yr olds) Preschool (3-6 yr olds) Elementary (1st-4th grade) Elementary (5th & 6th grade) Lobby Greeter Resource Room Exceptional Kids (Special Needs Buddy) Spanish Kids Ministry (Once a month - 5:00 p.m.) Weekday Office Help In which service would you like to serve?Select any that apply. 9:00 AM 11:00 AM 5:00 PM (Once a month - speaking Spanish is not required) Do you have a child that wants to serve with you?YesNoName of child serving with you:*Age of child serving with you:*Notes Legal QuestionnaireFor the protection of the kids, we must ask the following questions. Answering "yes" will NOT automatically disqualify you for this ministry, but we ask that you please explain any instances in which you checked "yes" in the space given at the end of the next section.1. Have you been convicted of any misdemeanor or felony?*YesNo2. Have you ever been convicted of a sexual offense or an offense relating to children, abuse, or crime of violence (if not already stated in first question)?*YesNo3. Have you ever been the subject of any disciplinary action, transfer or dismissal, as a result of an accident or mishap involving children?*YesNo4. Have you ever been accused, charged or alleged to have committed any act of neglecting, abusing, or molesting a child?*YesNo5. Have you ever been subject to any disciplinary action (including dismissal) or investigation by a church, religious or other organization, or by an employer?*YesNo6. Do you have any drug, alcohol, or substance abuse problems, or has anyone ever suggested you may have a problem?*YesNo7. Have you viewed pornography in the last 6 months?*YesNo8. Are you involved in a sexual lifestyle that is outside the bounds of marriage? Antioch defines marriage as a covenant union between one man and one woman.*YesNoOther Important QuestionsFor the protection of the kids, we ask the following questions. Answering "Yes" will NOT automatically disqualify you for this ministry, but we ask that you please explain any instances in which you checked "yes" in the space given at the end of this section.1. Have you struggled with gender identity or same sex attraction?*YesNo2. Are you currently taking medication that would affect your ability to competently care for kids?*YesNo3. In the past 6 months, have you had any instances or episodes where you were physically or mentally incapacitated?*YesNoPlease explain all questions to which you answered "Yes" in the above two sections: Legal Questionnaire/Other Important Questions.*4. Have you ever been sexually abused, or been the victim of abuse in any form?*YesNoPlease describe any counseling you have received for it.* Criminal Records Check AuthorizationI understand that to verify my suitability as a volunteer worker for the Kids Ministry, Antioch Community Church will request a criminal records search. I understand that the personal information will be held confidential by the kids ministry directors and church leadership. As a volunteer worker in Antioch Kids Ministry, I agree to observe and abide by the policies and safeguard measures of Antioch.* Agree Date of Birth* MM DD YYYY Location of Birth (City, State)*Social Security Number*Current Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Full Legal Name* First Middle Last Date* Date Format: MM slash DD slash YYYY Authorization SignatureBy signing below, I hereby authorize Antioch Community Church to obtain any information which pertains to any record of convictions maintained on me, whether local, state or national.*Please sign in the box. Personal ReferencesPlease give names, addresses and phone numbers of three references who have known you for a minimum of one year. If any of the categories do not apply, please substitute an additional reference. We will contact your references, so please make sure to provide current contact information. 1. Business Associate or Former Employer1. Name* First Last 1. Phone*1. Email* 2. Peer or Friend2. Name* First Last 2. Phone*2. Email* Do you need to include an additonal reference? (optional)YesNo3. Additional Reference (optional)3. Refernce type*3. Name* First Last 3. Phone*3. Email* Welcome Back!Since you indicated that you've volunteered for us within the last 18 months, we don't need any additional information from you at this point. We will be in touch soon to get you started! Code of Conduct for Child Safety Acknowledgement StatementPlease read the statements below in their entirety before responding.The responses I have provided in completing my application for Antioch Kids Ministry were complete, truthful and accurate. I hereby authorize Antioch Community Church to make inquiries concerning my background and authorize all persons associated with me, including churches, employers, law enforcement agencies, licensing and social services agencies, to release any information contained in their files or records concerning me to Antioch and its representatives.* I Agree I declare that I have not and will not engage in sexual abuse, or a pattern of physical, emotional, or spiritual abuse, or neglect of a kid. If I have been the subject of an allegation of a complaint, disciplinary action or dismissal due to such acts, regardless of the outcome of the allegation, I have notified the Antioch Kids Ministry.* I Agree I understand my responsibility to verbally report abuse and other inappropriate conduct toward a kid to my Department Head or the Child Safety Officer to implement Child Safety Procedures.* I Agree I understand Antioch takes allegations of child abuse seriously and that abuse in any form will not be tolerated. I understand that Antioch Community Church will cooperate with civil authorities in the investigation of any report of abuse.* I Agree Ministry Mentor ExpectationsAntioch Kids Ministry (AKM) is committed to supporting the growth of volunteer Ministry Mentors who increasingly love God, love others, and love those who do not know Jesus. Serving in Kids Ministry is a privilege and should be taken seriously.* I Agree How I live away from Kids Ministry1. I understand that I must be involved in or working towards getting involved in an Antioch Lifegroup.* I Agree 2. I understand it is vital that I am committed to growing personally in my walk with the Lord.* I Agree 3. I understand that as a volunteer my personal life will be observed by others. (Ephesians 4:17-5:8)* I Agree 4. I must be committed to living in authentic, biblical community. This means confessing my sin to the Lord and sharing struggles with other believers in my Antioch-based Lifegroup whom I know and are partnering with me for spiritual growth. (1 John 1:5-10; James 5:16)* I Agree 5. I am committed to biblical conflict resolution and am able to work in harmony with others. I must not be a person who consistently causes disputes or has consistent “personality conflicts” with other people. (Philippians 2:1-4; Ephesians 4:2-3; Matthew 18:15-20)* I Agree 6. I agree to walk in the fruit of the spirit as I lead people, looking to their best interest and encouraging their growth in God. (Galatians 5:22-23)* I Agree 7. I agree to pursue a life of purity and resist the temptations of sexual immorality, sex [outside of marriage], same sex attraction, pornography, drunkenness, illegal drug use. (1 Corinthians 6:18; I Timothy 3:2)* I Agree My Commitment to Kids Ministry1. I am willing to commit to serving in Kids Ministry for an initial six months. And, if I transition out of serving, I commit to communicating well with AKM Leaders through that transition.* I Agree 2. I am willing to receive feedback about my performance from AKM Leaders.* I Agree 3. I am able and willing to attend the once a quarter AKM team meetings.*(typically, on a Sunday afternoon) I Agree 4. I am able and willing to attend the pre-service meetings for Ministry Mentors on the days that I serve.* I Agree 5. I understand that it is my responsibility to communicate to my AKM team leader with advanced warning if I am unable to serve on a certain day. And, I am also willing to coordinate an AKM approved “stand-in” volunteer in my absence.* I Agree 6. If I discover I am not a good fit for my area in AKM, I will initiate with AKM Leaders to coordinate to find a better suited serving situation for me.* I Agree If you have any questions about any the statements above, please note them here.Applicant's Name* First Last Applicant's Signature*Parent or Legal Guardian Name* First Last Parent or Legal Guardian Signature*Parent StatementParent or Legal Guardian Name* First Last By Signing below, I, the parrent or legal guardian, understand the commitment that my kid is signing up for and agree to support him/her in fulfilling it by bringing them to the training, getting them there on time, and making sure that Antioch knows when my kid will be absent in the casees where they do not have email.* Note: If this form is not visible above this message, please email [email protected] to get more information about volunteering with Antioch Kids Ministry.