Northwest Family Church Volunteer Application

Northwest Family Church Volunteer Application This application to be completed by all those, over 13 years of age, desiring a volunteer position at Northwest Family Church (the Church ). It is used to help the Church provide a safe and secure environment for the children who participate here. The Church does not discriminate on the basis of race, color, national origin, sex, age or disability in its programs or activities, to the extent the law and regulations apply to the Church. As a religious non-profit organization, the Church may prefer employees and volunteers on the basis of religion. Legal Name: Last First Middle Male Female Address: Street City State Zip How long at this address? If less than ten years, give previous addresses for the last 10 years: 1. Previous address: Years: 2. Previous address: Years: 3. Previous address: Years: If you have ever used other names (maiden/alias) please provide complete name(s) and date in use: Name: Date: Birthday: / / Home Phone: Email: Cell Phone: Marital Status: Spouse s Name: Number of Children: Anniversary: Children s Names & Ages: Emergency Contact: Phone Number: Occupation: Place of Employment: Number of Years: MINISTRY PLACEMENT What is your availability & in what areas of ministry are you interested in being involved? Please check all that apply: Availability Discipleship Worship & Arts Sundays AM Altar Ministries Drums Sundays PM Bible Class Teacher Electric Guitar Tuesday Nights Bible Study Leader Acoustic Guitar Wednesday Nights Small Groups Bass Guitar Other: Lead one Percussion Family Life Ministry Assistant Keyboard Student Ministries (resonate) Host home Vocals Middle School Outreach Media Graphics High School Volunteer Technical College Chaperone Costuming Children s Ministry (NFC Kids) Food Bank Choir Nursery (0-1) Other: Drama Early Childhood (2-5) Hospitality Other: Elementary (K-5) Latte Stand Office Volunteer Mpact (K-5) Meal Preparation Website Rangers (K-5) Van/Bus Driver CDL? Y / N Publications Other: Greeter Usher Graphics Prayer Ministries Guest Services Writing Parking Board Approval Date: 1/17/08 1

Northwest Family Church Volunteer Application Please list your current work experience: 1. Employer s name: Phone: Supervisor: Please list your highest level of education completed: 1. School/Training: Degree and year of completion: Please provide the following information concerning your church attendance over the last 10 years: Church s & Pastor s Name: Leadership roles held by you: Church s & Pastor s Name: Leadership roles held by you: Church s & Pastor s Name: Leadership roles held by you: Phone: Phone: Phone: Please list the organizations for which you have offered volunteer services in the past 10 years. Organization s Name: Supervisor: Position at Organization: Phone: Dates of Volunteer Work: Reasons for leaving: Organization s Name: Supervisor: Position at Organization: Phone: Dates of Volunteer Work: Reasons for leaving: Organization s Name: Supervisor: Position at Organization: Phone: Dates of Volunteer Work: Reasons for leaving: Do you have a personal relationship with Jesus Christ? Do you regularly attend the Church s worship services? Are you a voting member of the Church? Have you led anyone to Christ? Have you been baptized in water? Have you been baptized in the Holy Spirit? How long have you attended NFC? Please provide your full testimony on the page provided. What are your top interests in life? (i.e. goals, hobbies, etc.) Please list any leadership training, education, gifts or other factors that have prepared you for this position: List any other Northwest Family Church ministries in which you have been involved: 2

Northwest Family Church Volunteer Application Personal Testimony PLEASE COMPLETE EACH QUESTION: 1. Describe how you came to faith in Christ. 2. In what areas of your life has your relationship with Christ been most transforming? 3. How would you best describe your journey with God at this present time? 4. Briefly describe your personal devotions/bible study. 3

Northwest Family Church Volunteer Application Please list three personal references, not relatives or supervisors, whom you have known at least three years. If you intend to work with minors at the Church, two of the three references must speak to your ability to work with minors. Name: Address: Name: Address: Name: Address: Relationship: Phone: Relationship: Phone: Relationship: Phone: The questions below are part of the process to help provide a safe and secure environment for our children. It is our desire to assist you to find a ministry that is fulfilling and suited to your strengths and experiences. If you answer YES to the questions below, please include the details and an explanation on a separate piece of paper. Answering YES to the questions will not necessarily bar you from volunteer service. 1. Have you ever been convicted of a crime (misdemeanor or felony)? A conviction includes any conviction in any jurisdiction including convictions by way of trial, pleas (guilty, Alford, nolo contrendre, or no contest even if they were later withdrawn), deferred prosecution, suspended sentence or stipulation. Conviction shall also include convictions that have subsequently been dismissed expunged, vacated, reduced, mitigated, or otherwise stricken from official record. 2. Are there any facts or circumstances that would call into question your involvement in an environment where minors may be present? 3. Have you ever been charged or convicted of a sexual offense, offense relating to minors or a crime of violence? 4. Have you had any experiences (physical, sexual or emotional abuse or neglect) that have better equipped you or may hinder you in ministry to minors at the Church? 5. Have you viewed pornography within the last year? 6. Do you use tobacco, alcohol or illegal drugs? 7. Have you ever been reported to or investigated by a social services agency, law enforcement authority, child abuse registry or similar organization in any state or jurisdiction regarding abuse, neglect or misconduct involving minors? 8. Have you ever been a party to a civil lawsuit involving sexual abuse, misconduct or harassment, violent behavior or an accident or mishap involving adults or minors? 9. Have you ever been the subject of a complaint or disciplinary proceeding against a professional license or other license held by you including, but not limited to, a license to provide childcare or similar services? 10. Have you ever been subject to any disciplinary action (including discharge) or investigation by a church, religiously affiliated or nonprofit organization or by an employer? 4

Northwest Family Church Volunteer Application My answers in this application are true and correct and complete to the best of my knowledge. I understand that any false, incomplete, or misrepresented oral or written statement of any kind contained in my application materials, or made in the course of any related application process, whether made by me or by others at my request, may result in my disqualification for volunteer services, or termination of my volunteer status. I understand and agree to be bound by the bylaws and policies of the Church, and to refrain from any conduct in violation of the Church s teachings or the bylaws and policies of the Church. If I serve as a volunteer, I understand and agree that the Church expects me to refrain from behavior that conflicts with Christian standards including immoral cohabitation; alcohol or substance abuse, including drunkenness and illegal drug use; and inappropriate speech, such as vulgar or sexually suggestive words, and gossip; and insubordination. I understand and agree that no offer or promise of volunteer status has been made. I understand and agree that if I serve as a volunteer, my status at the Church is at will, which means that either the Church or I can terminate the relationship at any time, with or without prior notice, and for any reason. I understand that no representative of the Church, other than the Senior Pastor, has any authority to enter into any agreement for volunteer services for any specific period of time, or to make any agreement contrary to the foregoing. I have read and signed the Release (Exhibit 1), the Church s Vision & Statement of Faith (Exhibit 2), the Volunteer Screening Process & Mandatory Child Abuse & Neglect Obligations (Exhibit 3), and the Release & Permission to Procure a Report (Exhibit 5). Signature Date Acknowledgment I have received, read and understand the Volunteer Screening Process and Mandatory Child Abuse & Neglect Obligations dated, (collectively referred to as the Screening Process ). I understand and agree that the Screening Process does not create any contractual rights, but only set forth Northwest Family Church s (the Church ) general policies regarding volunteer conduct. I also understand and agree that the policies contained in the Screening Process are subject to change and interpretation by the Church. I understand and agree that the Church or I may terminate my services at any time, with or without cause or advance notice. I understand and agree that the Screening Process supersede all previous manuals, publications or policy statements, written and verbal, regarding the Church s general policies on volunteer conduct. I have been afforded an opportunity to ask questions of the Church regarding these guidelines. I authorize the Church to request criminal background checks on me and copies of my driving record (if I may operate a commercial vehicle on behalf of the Church) during the course of my volunteer work with the Church. I also understand and agree that the Church may inspect and monitor offices, desks, files, computers (including software, Internet, and e-mail systems), and telephones (including, but not limited to, voice mail files) and all other property owned, leased or used by the Church or provided to the Church employees at any time in the Church s sole discretion. I hereby acknowledge receipt of the Screening Process and agree to the terms provided in the Acknowledgment. Name (Please Print) Signature Date 5

Exhibit 1 - RELEASE INCLUDES AUTHORIZATION OF RELEASE OF INFORMATION, AND DEFENSE, INDEMNIFICATION AND HOLD HARMLESS OBLIGATIONS BY APPLICANT I,, have applied at Northwest Family Church (the Church ) as a volunteer. I authorize the Church, in its efforts to process my application and to check my background and contact references, to provide a copy of this release to any person or entity, and authorize the Church and other parties to treat a facsimile copy of this release as if it were the signed original. I authorize the Church to contact any person or entity to obtain information about me, including the employers, organizations, supervisors, governmental agencies and references that I list in my application and others identified by the Church. Without limiting the foregoing, I understand and agree that this release allows the Department of Social and Health Services, including Child Protective Services, to release information concerning me. I hereby request, consent to, and authorize any current or former employer, person, firm, corporation, organization, education or vocational institution, or government agency to provide the Church with information they have regarding me, including the release of information concerning my performance, qualifications, personal and work history, dates of employment, dates of volunteer service, job titles, reasons for leaving, salary, and opinions about me. The released information may be in the form of a letter of reference, a response to an evaluation form prepared by the Church, telephone interviews or other interviews initiated by the Church, or any other means deemed appropriate by the Church. I understand that the information released may include facts and/or opinions that are unfavorable to me and/or with which I may disagree. I hereby expressly waive any and all rights I may have of access to any letter of reference, to any response to an evaluation form, to anything discussed in telephone conversations or interviews, or information otherwise obtained by the Church, including any right to inspect and review, any right to have a copy made for my use, and any right to request an amendment of, or correction to, any released information. I hereby release and agree to defend, indemnify and hold harmless the Church and its past, present and future pastors, elders, deacons, leaders, employees, directors, officers, volunteers, agents, successors and assigns, and insurers from any and all liabilities arising from, or in any way related to requesting or receiving information about me. I also release and agree to defend, indemnify and hold harmless any person or organization or entity (whether listed in my application or not) and its respective directors, owners, officers, employees, volunteers and agents who provide information or references about me to the Church from and against any and all liability arising from, or in any way related to, their disclosure of any information or opinions about me. I hereby acknowledge that I have read, understand, and willingly sign and agree to this document. THIS STATEMENT CONTAINS A RELEASE OF CLAIMS AND AN OBLIGATION TO DEFEND, INDEMNIFY AND HOLD HARMLESS THE CHURCH AND OTHERS. PLEASE READ IT CAREFULLY. This signed release must be a part of the application package. The release must be mailed, faxed, or taken to the Church for the application to be considered complete. Signature Date 6

Exhibit 2 CHURCH S VISION & STATEMENT OF FAITH Northwest Family Church Vision Mission connecting people to Jesus and each other Purposes experiencing learning sharing serving belonging Values biblical preaching empowering leadership relevant ministry relational outreach authentic relationships We Believe the Bible is the inspired and only infallible and authoritative written Word of God. 2 Timothy 3:16 there is one God, eternally existent in three persons: God the Father, God the Son, and God the Holy Spirit. Deuteronomy 6:4; Matthew 28:19 in the deity of our Lord Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarious and atoning death, in His bodily resurrection, in His ascension to the right hand of the Father, in His personal future return to this earth in power and glory to rule a thousand years. John 1:1 in the blessed hope the rapture of the Church at Christ s coming. Titus 2:13 the only means for being cleansed from sin is through repentance and faith in the precious blood of Christ. John 14:6 regeneration by the Holy Spirit is absolutely essential for personal salvation. Titus 3:5 in water baptism by immersion. Matthew 28:19 the redemptive work of Christ on the cross provided healing of the human body in answer to believing prayer. 1 Peter 2:24 the baptism in the Holy Spirit, according to Acts 2:4, is given to believers who ask for it. in the sanctifying power of the Holy Spirit by whose indwelling the Christian is enabled to live a holy life. Galatians 5:16-25 in the resurrection of both the saved and the lost, the one to everlasting life and the other to everlasting damnation. Revelation 20:11-15 7

Exhibit 3 VOLUNTEER SCREENING PROCESS MANDATORY CHILD ABUSE & NEGLECT OBLIGATIONS In order to ensure the safety of our minors and workers, the Church follows these screening guidelines for its volunteers: SCREENING PROCESS 1. Volunteer Application & Background Check prior to working with minors on behalf of the Church, volunteer applicants must: a) Complete a Volunteer Application and Release & Permission to Procure Background Check Form; b) Sign an acknowledgment that they have reviewed this Volunteer Screening Process and any other pertinent Church policies; c) Undergo a criminal history background check; d) Complete a personal interview with a person designated by the Church; e) Sign an acknowledgment that they have reviewed these guidelines and any other pertinent Church policies; f) Complete any membership and leadership or training classes required by the Church, with written documentation supporting attendance; and g) Adhere to the Church s Vision, Statement of Faith and regularly attend the Church s worship services. 2. Minors Who Serve As Volunteers: Minors should also provide a written statement from their parents stating that the parent knows of no reason why the minor should not be allowed to work directly or indirectly with other minors. SeeExhibit 5, Permission For Minor To Volunteer. 3. Adult Survivors. Adult survivors of childhood abuse are strongly encouraged to meet with a pastor before working in any capacity with minors. 4. Past Criminal Conduct. A volunteer who has been convicted or has pled guilty to either child sexual or physical abuse or neglect or any misconduct involving minors are not eligible to work with minors on behalf of the Church. REPORTING PROCEDURE FOR ABUSE OR NEGLECT ALLEGATIONS 1. Definition of Abuse For purposes of reporting child abuse and neglect, Washington law defines a child as a person under the age of 18. Washington law defines abuse or neglect as " the injury, sexual abuse, sexual exploitation, negligent treatment, or maltreatment of a child by any person under circumstances which indicate that the child's health, welfare, and safety is harmed, excluding conduct permitted under RCW 9A.16.100." RCW 26.44.020 Child abuse may be violent or non-violent. All child sexual abuse is an exploitation of a child s vulnerability and powerlessness in which the abuser is fully responsible for the actions. Child sexual abuse is criminal behavior that involves children in sexual behaviors for which they are not personally, socially, and developmentally ready. Child abuse and neglect includes both physical and non-physical aspects. The effects of child abuse are ongoing and affect the victim mentally, emotionally, physically, socially, and spiritually. The profile of a child molester is varied. Often we think of strangers in trench coats or dirty old men. Over eighty percent of the time, the typical child molester is someone known and trusted by the victim. Most abuse takes place in the context of ongoing relationships. Adult child abusers may be married and have children. The non-similarities in the molester profile means we should not make assumptions about who might be a child molester. The Church recognizes that Washington law requires certain persons to report suspected abuse or neglect to government officials and it encourages employees to fully comply with Washington reporting requirements. 2. Internal Reporting Obligations Employees and volunteers who have reasonable cause to believe that abuse or neglect has occurred must discuss the matter with the supervising ministry pastor/director, or senior pastor within 24 hours and, if possible, prior to reporting to government officials. If a supervising ministry pastor/director receives the report, he or she should contact the senior pastor immediately. In addition, employees and volunteers should discuss any behavior that may be perceived as inappropriate, suspicious, or harmful in any way to the Church, its workers or ministry participants (including minors) with a supervisor as soon as possible. 8

Exhibit 3 VOLUNTEER SCREENING PROCESS MANDATORY CHILD ABUSE & NEGLECT OBLIGATIONS 3. External Reporting Obligations Any employee or volunteer who, in a supervisory role for the Church, has reasonable cause to believe that a child has suffered abuse or neglect is required by Washington law (RCW 26.44) to report child abuse or neglect to the proper law enforcement agency, provided the abuse or neglect was caused by a person: a) whom he or she regularly supervises, b) who is employed by, contracted by, or volunteers for the Church, and c) who regularly has unsupervised access to minors. Washington law requires that all reports required to be made under RCW 26.44 must include the name of the accused if known and be made within 48 hours. In addition, the reporting obligations required by Washington law apply to other persons including, but not limited to, any practitioner, county coroner or medical examiner, law enforcement officer, professional school personnel, registered or licensed nurse, social service counselor, psychologist, pharmacist, licensed or certified child care providers or their employees. The employee or volunteer shall report the incident pursuant to the internal reporting procedures. A Church representative designated by the senior pastor may report the incident to local police or the government officials even if the employee or volunteer is not required by law to do so. Employees or volunteers with mandatory reporting obligations under Chapter 26.44 RCW are not relieved of their obligations by simply reporting the incident to Church personnel. If an employee has a question as to whether they are a mandatory reporter, they should contact the senior pastor. 4. General Guidelines When Abuse or Neglect is Suspected In addition to the reporting guidelines provided above, the senior pastor should take the following steps when handling an allegation of abuse or neglect: a) contact the Church s attorney as soon as possible, preferably before a report is made to government officials so that the attorney can advise the Church on reporting obligations and the appropriate investigative action; b) request guidance from the government agency to whom the report was made to determine whether it recommends the Church take any further steps to investigate the allegations; c) consider what steps should be taken to ensure the safety of other Church attendees and to facilitate the Church s ministry to the victim and abuser, when appropriate. d) if the accused is a volunteer or employee of the Church, immediately ask the accused to take a leave of absence pending investigation of the allegations. The Church retains the sole and absolute discretion to determine whether leave is paid for employees. e) external abuse reporting should be documented by the reporter. Similarly, any action taken against the accused should be similarly documented in writing. This includes any restrictions placed on the accused by the Church during the investigation. STANDARDS OF CONDUCT IN RELATIONSHIPS Volunteers must maintain appropriate Christian relationships with others in the context of their volunteer roles. Relationships must maintain a correct and balanced focused based on the approved ministry of service being provided. Volunteers must refrain from inappropriate activities including, but not limited to, the following: 1. using tobacco products or alcohol while on the Church s premises or representing the Church or in the presence of minors; 2. manufacturing, using, selling or dispensing unlawful controlled substances; 3. using inappropriate speech or gestures, which may include, but is not limited to, profanity, demeaning or humiliating speech, or sexually-suggestive words or gestures; 4. engaging in inappropriate personal involvement or understandings with Church attendees including, but not limited to, arranging to spend time alone with a minor who attends the Church and is not related to the volunteer; arranging a non-approved or inappropriate meeting with a person away from Church facilities; or sharing close personal problems of a highly emotional nature with a person whom you supervise or serve in your ministry capacity. 5. engaging in fornication, adultery, homosexuality or cohabitation. Biblical standards for human sexuality prescribe a heterosexual monogamous relationship within the covenant of marriage and sexual chastity for those who are unmarried. 9

Exhibit 3 VOLUNTEER SCREENING PROCESS MANDATORY CHILD ABUSE & NEGLECT OBLIGATIONS CONSEQUENCES FOR VIOLATIONS Volunteer work at the Church is a privilege, not a right. In addition to possible criminal sanctions for violation of child abuse reporting law, the Church reserves the right to take disciplinary actions against volunteers who violate the Volunteer Screening Process, as the Church deems appropriate in its sole and absolute discretion. Such consequences may include, but not be limited to: 1. reminders of the Volunteer Screening Process and discussion regarding inappropriate behavior. 2. removal or termination from his/her position and barred from participating in such ministries. The Church may skip steps in the disciplinary process and may terminate the services of a volunteer at any time with or without cause or advance notice. 10

Exhibit 4 Permission For Minors To Volunteer Release, Medical Consent & Payment of Expenses Name of Minor: Position: Minor s Date of Birth: Name of Parents/Guardians: Address: Home Phone: Cell Phone: Permission to Volunteer. The Parent, the undersigned parent(s) or legal guardian(s) of the Minor identified above, grants permission for the Minor to provide volunteer services to Northwest Family Church (the Church). The Parent understands that the volunteer service includes:. Medical Consent. The Parent grants permission to the Church and its employees and agents to take the Minor to a physician for medical treatment, emergency surgery, or hospitalization or to call 911 for emergency medical aid if, in the Church s sole and absolute judgment, the Minor becomes ill or sustains an injury or otherwise requires medical treatment. The Parent gives consent to any physician or emergency aid responder to administer drugs or medicine or to perform such medical procedures as that physician or responder determines necessary for the relief of pain or to preserve the Minor s life or health. The Parent assumes full responsibility for all medical, transportation, rescue and other expenses incurred on behalf of the Minor and will fully and immediately reimburse the Church for any of these expenses that the Church, in its sole and absolute discretion, chooses to advance. Release of Claims. In this Agreement, Claims means all claims, demands, damages, actions, fees, costs, expenses, liabilities, awards, or judgments known or unknown, foreseen or unforeseen related to or arising from the Church s acts or omissions regarding the Minor except to the extent caused entirely by the Church s gross negligence or intentional misconduct. The Parent hereby forever releases the Church from all Claims. This release of Claims ( Release ) is binding upon the Parent and any other person who asserts any Claim through the Parent or on the Parent s behalf. To the extent that the law may allow at any time in the future, this Release is also binding upon the Minor and any other person who asserts any Claim through the Minor or on the Minor s behalf Indemnification. To the extent the Release is not abided by or is held to be ineffective, in whole or in part, the Parent agrees to indemnify and defend the Church against all Claims of the Parent and of the Minor including, without limitation, paying all attorney fees and costs that the Church incurs related to a Claim. This document contains a release and waiver of liability. Please read carefully before signing. Parent/Guardian Signature Date Parent/Guardian Signature Date Minor Signature Date 11

Exhibit 5 - RELEASE & PERMISSION TO PROCURE A REPORT Please type or print legibly name as it appears on your driver s license or government issued photo ID. LAST FIRST FULL MIDDLE STREET ADDRESS CITY STATE ZIP CODE Please list other names used and dates of name change in the last ten years: FULL NAME DATE DOB: / / SSN: DRIVER S LICENSE #: STATE: Have you ever been convicted of a crime (misdemeanor or felony)? If yes, please provide details of all convictions and locations of all convictions. Attach a sheet if necessary. A yes answer will not necessarily disqualify you from employment or volunteering. RESIDENCES: Please list residences in the last 10 years State City County Years to State City County Years to State City County Years to I, the undersigned, desire to provide volunteer services to Northwest Family Church (the Church ). This relationship is initiated by me. In an effort to provide a safe environment for those who attend the Church, I am requesting that the Church obtain a consumer report on me for purposes of evaluating me for possible volunteer services and I agree that this is a legitimate business purpose. I further understand and agree that if I am selected as a volunteer, this document may also be used by the Church to request consumer reports on me for purposes of evaluating my retention as a volunteer. I hereby agree that a photographic copy or a telephonic facsimile of this document shall be valid for all purposes present and future. I understand that information obtained from any consumer report shall be used solely for the purpose of making decisions regarding my volunteer status. I further understand that, upon my written request, the Church will provide me with a complete and accurate disclosure of the nature and scope of the consumer report requested and a copy of my rights, if any, under the Fair Credit Reporting Act. RELEASE: I, the undersigned, hereby release and discharge to the extent permitted by law, Northwest Family Church and its directors, officers, employees, volunteers, and other agents, and any individual or agency obtaining information for Northwest Family Church, from any and all claims known or unknown, damages, losses, liabilities, costs, or other expenses arising from the retrieving, reporting, and/or disclosure of information in connection with obtaining any consumer reports (as described above) related to me. I understand and agree that nothing in this document shall limit or supersede any other document I have signed or may sign regarding background checks, reference checks or other matters. Signature Date Please place a copy of your DRIVER S LICENSE or GOVERNMENT ISSUED PHOTO ID HERE 12