PEACHY

PEACHY Ministry Application Form

Legal Name Required

Age Required

Address Required

City, State Required

Phone Required

Email Required

Where are you a church member? (If not FBCK, give church name and city/state. If not a member anywhere, respond "None".) Required

History

List any other names you are (or have been) known by

List any other addresses you have lived at over the last five years.

List any churches (other than FBCK) you have regularly attended during the last five years. Include church name, city, state, and dates.

List any other experience you have working with infants, children, youth, or vulnerable adults. Include organization (e.g., church name) and location, program name, dates, and POC. (Limit to most recent 3.)

Legal

Have you at any time ever been convicted of, or pleaded guilty to or no contest to, any crime? (do not include minor traffic citations or civil judgements) Required

Yes

Have you at any time ever participated in, or been accused, convicted, or pleaded guilty or no contest to abuse or any sexual misconduct? Required

Yes

Are you aware of having any traits or tendancies that could pose any threat to chldren, youth, or others? Required

Yes

Are you aware of any reason why you should not work with children, youth, vulnerable adults, or others? Required

Yes

If the answer to any of these questions is "yes", please explain in detail.

References

Provide at least two independent references, including name, relationship, and contact information. Do not include family members or relatives. Past ministry leaders, pastors, or employers preferred. Required

Verification and Release

I recognize that First Baptist Church of Kingstowne (FBCK) is relying on the accuracy of the information I provide on this application form. Accordingly, I affirm that the information I have provided is true and correct.

I authorize FBCK, or its agents, to contact any person or entity listed on this application form, and I further authorize any such person or entity to provide FBCK, or its agents, with information, opinions, or impressions relating to my background or qualifications.

I voluntarily release FBCK, or its agents, and any such person or entity listed on this application form from liability involving the communication of information relating to my background or qualifications.

I have read the policy and procedures of FBCK, and I agree to abide by them. I understand that failure to follow procedures could result in dismissal from ministry roles. I agree to protect at all times the health and safety of infants, chilldren, youth, or vulnerable adults assigned to my care or supervision.

Name Required

Today's date Required

By clicking "Submit", I so affirm.