Name
*
First Name
Last Name
Email Address
*
Birth Date
*
MM
DD
YYYY
Current Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Cell Phone
*
(###)
###
####
Marital Status
*
Children's Name and Ages
Do you have a personal relationship with Jesus Christ?
*
Briefly describe your relationship with Jesus Christ.
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Are you a member of Patterson Park Church?
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How long have you been attending?
*
Please list other churches you have attended regularly in the past five years (include address, phone numbers, and point of contact).
*
Please describe why you would like to minister to children at Patterson Park Church.
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In what area of ministry do you desire to serve?
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Please list any previous church work or non-church work you have done with children (list organization's name and type of work performed).
What gifts, training, education or other factors have prepared you for working with children?
Do you have any special talents or abilities you would like to use in ministry- such as musical abilities, storytelling, drama, puppetry skills, administrative skills, professional skills- teacher/doctor/nurse or other?
List any other Patterson Park Church ministries in which you are involved.
Please list your adult Sunday school class and any other Bible Study classes you have attended in the past 2 years.
Which worship service do you regularly attend on Sundays?
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Please provide two references. Must be non-relatives and individuals you've known in a professional or volunteering capacity, preferably ones who have observed you working with children.
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Have you had any painful experiences in your life that you feel may better equip you or may hinder you from a productive ministry with children?
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Yes
No
Option Two
Would you like to meet with a pastor regarding this circumstance?
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Yes
No
Do you use illegal drugs?
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Yes
No
Have you ever been hospitalized or treated for alcohol, substance abuse or mental health issues?
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Yes
No
Have you ever been arrested for a criminal offense, excluding minor traffic violations?
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Yes
No
Have you ever been accused, arrested or convicted for any sexually related crime?
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Yes
No
Have you ever been involved with pornography in the past six months?
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Yes
No
Have you ever been accused, arrested or convicted for any abuse related crime?
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Yes
No
If you answered yes to any of the above questions, please explain.
