VOLUNTEER APPLICATION

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1 VOLUNTEER APPLICATION I. General Information Name Date of Birth Address City State Zip Day Phone Cell Phone Evening Phone Occupation Employer II. Volunteer Service A) Why are you interested in volunteering for ministry with children/youth? B) What prior experience do you have working with children/youth? C) What gifts and talents would you bring to this ministry area? D) Do you have first aid training (not required to be eligible for volunteer work) Yes No If yes, date completed E) Do you have CPR training (not required to be eligible for volunteer work) Yes No If yes, date completed

2 III. Faith Journey A) Are you a member of Peachtree Presbyterian Church? Yes No If yes, how long have you been a member? If not, to what church do you belong? B) How did you become a Christian and know Jesus Christ as your personal savior? C) Who has most influenced you in your desire to serve the Lord and why? D) Statements of Faith Peachtree Presbyterian Church is a community of believers in Jesus Christ as Lord and Savior. are a Christian Protestant church of the Reformed tradition. We We believe in one God who is sovereign over the world. We believe in the Trinity one God manifest in three persons: God the Father, Christ the Son, and the Holy Spirit. We believe Jesus Christ died on the cross to save us from sin in order that we might be reconciled to God and have a personal relationship with him. We believe in the resurrection of Jesus Christ We believe in the incarnation of the eternal Word of God in the person of Jesus Christ, who was both fully man and fully divine. Scripture tells us that we are made right with God by the grace of God through faith in Jesus Christ as our Lord and Savior. For us, scripture is the final authority for salvation and our guide for how to live the life of faith. As faithful stewards of all God s creation, we are called to live in obedience to the Word of God. I affirm my acceptance of these theological statements and agree to carry out my volunteer responsibilities in accordance with them. Signature Date

3 IV. Preliminary Security Information A) Have you ever been arrested for, charged with, convicted of, and/or plead guilty to a crime, either a misdemeanor or a felony, including, but not limited to, drug-related charges, child abuse, other crimes of violence, theft, or motor vehicle violations? If yes, please explain fully B) Have you ever been exposed to an incident of child abuse or neglect? Yes No C) Do you use and/or distribute illegal drugs? Yes No D) Are you currently being or have you ever been treated for drug or alcohol abuse? Yes No If yes, please explain fully V. Applicant s Statement The information contained in this application is true and correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) they may have regarding my character. Should my application be accepted, I agree to be bound by the laws and policies of Peachtree Presbyterian Church, and to refrain from unscriptural conduct in the performance of my service on behalf of the church. Applicant s Signature Date

4 VI. References Please provided the below information for three (3) personal references. Your personal references may not be persons related to you by blood and/or marriage. Please list at least one reference who has been known to you for a minimum of five (5) years and another reference who is a member of Peachtree Presbyterian Church. Name Phone Number Address City State Zip Relationship (to you) Length of Relationship Name Phone Number Address City State Zip Relationship (to you) Length of Relationship Name Phone Number Address City State Zip Relationship (to you) Length of Relationship

5 Please sign and return this page with application ACKNOWLEDGEMENT OF RECEIPT OF CHILD PROTECTION POLICY I acknowledge that I have received a copy of Peachtree Presbyterian Church s Child Protection Policy. I agree to read it thoroughly and to seek clarification of any policy or provision that I do not understand by contacting the director of the ministry area in which I plan to volunteer and/or the Operations Office. I further agree to fully and completely abide by the provisions set forth in Peachtree Presbyterian Church s Child Protection Policy. I understand that any failure to do so could result in a revocation of my volunteer approval status. DATE: PRINT NAME: SIGNATURE:

6 APPLICANT KEEPS THIS PORTION VII. Child Protection Policy Peachtree Presbyterian Church - Program Ministry-Child Protection Policy I. The Program It is our intention to provide a safe and secure environment for the children and youth who participate in our ministry. For the purposes of this policy, children and youth are collectively referred to as minors, and minor is defined as any individual under the age of 18 years and/or any individual who is developmentally disabled. A. Program Staffing Guidelines All Ministry Programs are staffed by paid staff and/or adult members of Peachtree Presbyterian Church.* The placement of volunteers in leadership roles with minors is governed by the following guidelines: 1. Adult is defined as an individual who is at least 18 years of age 2. We strive to maintain the following adult/minor ratios in our programs: 1 to 4 for infants and crawlers 1 to 6 for wobblers and toddlers 1 to 8 for preschoolers (Ages 2-6) 1 to 10 for minors 6 years and above 3. Two-adults rule: two adults must supervise any group of minors at all times; at no time will any minor or group of minors be left in the care of only one adult. The only two exceptions to this rule are: Contact which occurs in a public place with prior approval of parents Retreat/Travel Events which are governed by the following guideline: at least one same sex adult in a room/cabin/tent with no more than a 1 to 7 ration between adult and minors 4. Application and Screening of paid Peachtree staff: members of the paid staff are subject to application and screening policies of the Personnel Committee of Peachtree Presbyterian Church. 5. Application and Screening Policy for all volunteers a. All ministry volunteers will complete an application process appropriate for the position they wish to hold b. All volunteers whose responsibilities bring them in direct contact with minors who are outside the care of their parents will undergo a national criminal background check before working with minors. c. All volunteers will be re-screened at 3-year intervals *Because of its broad community impact, the Recreation Ministry permits some athletic coaches and instructors to be members of other Christian congregations. While serving as volunteers in Peachtree programs, these adults are bound by the regulations of this policy. *Student Ministry volunteers are subject to a separate Child Protection Policy which is responsive to the needs of pre-teens and teenagers.

7 II. B. Identification and Classroom Access 1. All volunteers and staff will wear proper identification 2. The interior of all classrooms must be visible from the hallway. 3. All nursery and preschool children must be signed in and out of their Sunday School classroom by their parent/guardian or an adult designated by a parent/guardian; all nursery and preschool classrooms will utilize the name tag/security tag system 4. Only children and assigned ministry volunteers/staff will be allowed in classrooms. Parents/Guardians are expected to sign-in their child at the door and release the child to the care of volunteers/staff in the classroom. Parents/Guardians should not enter the classroom. Volunteer Personnel It is our intention to staff ministry programs with volunteers who are appropriately matched, screened, and trained with regard to safety for the responsibilities they are assigned. A. Becoming a Peachtree Ministry Volunteer Individuals who wish to volunteer in ministry positions related to minors will complete the Application Process outlined below. 1. Be a member of Peachtree Presbyterian Church who is at least 18 years old when he or she begins working (see Section I, A, footnote, for church membership exception). 2. Express an interest in participating in ministry at Peachtree. 3. Complete an application form which includes providing references and granting permission for church staff to initiate a national criminal background check (if required for the position the individual wishes to hold). 4. Interview with a member of the Peachtree staff. 5. Undergo a reference check (required for any volunteer whose responsibilities bring them in direct contact with minors who are outside the care of their parents). 6. Undergo a national criminal background check (required for any volunteer whose responsibilities bring them in direct contact with minors who are outside the care of their parents) 7. Accept a specific placement in conversation with Peachtree ministry staff 8. Complete training as required for the position the individual will hold. Such training will include instruction regarding security issues and procedures at Peachtree Presbyterian Church. B. Age Requirement All ministry programs are staffed by adult members of Peachtree Presbyterian Church. Members of the Peachtree family who are under the age of 18 may volunteer in ministry. In this policy, these volunteers are referred to as youth-aides. Their roles and responsibilities are guided by the following standards: 1. All youth-aides complete the Application Process outlined in Section II, A, 1-8 of this policy with the exception of Step All youth-aides whose responsibilities bring them in direct contact with minors who are outside the care of their parents must work under the supervision of two approved adult volunteers. At no time may a youth-aide volunteer function in an adult role. 3. Youth-aides who wish to volunteer in classroom situations (i.e. Sunday School or VBS classrooms) must be juniors or seniors in high school, have the recommendation of a member of the Peachtree Youth Staff, and be confirmed members of Peachtree Presbyterian Church. 4. Youth-aides whose responsibilities bring them in direct contact with minors who are outside the care of their parents must be at least three years older than the minors with whom they are interacting. 5. Youth-aides who wish to volunteer in the church nursery:

8 a. Must be at least 12 years old b. Must complete a child-care training course offered by Peachtree Presbyterian Church OR Scottish Rite s Super Sitters training program (certificate of completion presented to Peachtree Staff) c. May not change diapers d. May not pick up or carry children C. Application Form Volunteer applicants will complete an application form, providing their: 1. Contact information (address, phone, etc.) 2. Church history 3. Any experience working with minors 4. Acceptance of Peachtree s theological statement 5. Permission for church staff to initiate a national criminal background check 6. References D. Interview Each applicant will interview with a member of the Peachtree staff. A personal interview begins the process of building a relationship between staff members and the volunteers who work with them; explores the potential volunteer s reasons for volunteering; ascertains the most appropriate placement in the program for the volunteer; provides staff member and potential volunteer the opportunity to ask questions and provide information about the ministry, specific programs, and responsibilities; and allows for follow-up on information provided on the application form. E. Reference Check Applicants will be asked to provide three personal references. One of these references must be a member of Peachtree Presbyterian Church. If the applicant has been a member of Peachtree Presbyterian Church for less than one year, one reference must be a staff member from the applicant s former church (if applicable). At least one of the three references must have known the applicant for a minimum of five years. F. Criminal Background Check 1. Every individual applying to volunteer for responsibilities which bring the volunteer in direct contact with minors who are outside the care of their parents will be asked to grant permission for a staff member to initiate a national criminal background check. 2. Applicants who choose not to grant permission for a national criminal background check will not be considered for responsibilities which bring the volunteer in direct contact with minors who are outside the care of their parents. 3. All information obtained through the national criminal background check will be held in confidence. The Executive Director of Operations will review the reports and will be the only person with access to the information contained in them. 4. All information obtained through the national criminal background check will be used for the sole purpose of determining an applicant s suitability for the desired position. III. a. No one with known prior incidents of physical or sexual abuse, child neglect, child exploitation, or other forms of sexual misconduct will be utilized in any capacity in contact with minors. b. Other incidents appearing on the national criminal background check will be weighed against the responsibilities of the position for which the individual has applied. Exceptions Any exceptions to this policy must be approved by the Property Committee, under the direction of the Executive Director of Operations.

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