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VOLUNTEER FORM
CONTACT US
Interested in volunteering at Porter First Baptist Church?
Please complete the following form. Your answers will be kept confidential.
First Name
Last Name
Email
Address 1
Address 2
Country
City
State
Zip/Postal Code
Cell /Home Number
How long have you lived at your current address?
What was your previous address?
List all the other cities and states where you have lived as an adult:
Please list all previous volunteer work involving children.
In the box below list:
1. Organization’s name
2. Organization's address
3. Type of volunteerism at this organization
4. Dates volunteered at this organization
5. A contact person and phone number for this organization
PLEASE DO THIS FOR ALL VOLUNTEER JOBS WITH CHILDREN BELOW.
List any talents, vocations, preparation, training or other experiences that have equipped you to work with children:
Volunteerism Reference: Please include Full Name and Phone Number
Personal Reference: Please include Full Name and Phone Number
Family Member Reference: Please include Full Name and Phone Number
Because we care for children and desire 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 in every possible context. It is the position of Porter First Baptist Church that suspicions or allegations of child abuse or neglect will be reported to relevant state authorities.
Why do you want to work with children at Porter First Baptist Church?
Do you have a preference concerning the age group or sex of children with whom you would like to work? If so, what is the basis for this preference?
What is your philosophy concerning re-direction or discipline of children?
When you are unhappy, angry or emotional about a person or circumstance, what do you do?
Have you experienced any significant physical or emotional stressors within the past year, such as the loss of a parent, spouse, or child, extreme ill health, or any emotional or physical crisis? If so, please briefly explain. (Use back of page if necessary.)
Have you ever physically or sexually abused a child?
Yes
No
Has someone ever accused you of physically or sexually abusing a child, or molesting a child?
Yes
No
Do you consider yourself to have been physically or sexually abused as a child?
We realize this information is potentially sensitive, and it will be kept entirely confidential, where another child’s safety is not negatively impacted by confidentiality.
Yes
No
If you answered 'yes' to the previous questions please explain:
If you answered ‘yes’ to the previous question, would you consider counseling or resources (available through the Porter First Baptist Church) to address any resulting emotional or spiritual harm or damage?
Yes
No
RELEASE
I authorize Porter First Baptist Church to contact all individuals, organizations and references listed on this Volunteer Application Form in order to verify the information I have provided. I agree to release from liability any person or organization providing information related to me, including those persons I have listed as references, as well as contact persons from my previous volunteer work with children. I understand and agree that any information received from the application verification will not be disclosed to me except as required by law, and I hereby waive any right I may have to inspect any information provided about me by any person or organization identified by me on this form. By signing this form, I certify and affirm that the information I have given on this form is true, complete and correct in all respects.
I Agree
Today's Date:
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