Volunteer or Employee Application Form

543 Ockley Drive

Shreveport, LA 71106

(318) 865-8414 office (318) 865-8450 fax

Website: www.fbcshreveport.org

This application form is to be completed by all volunteers, workers, and employees for any position of First Baptist Church of Shreveport. Our goal is to provide a Christ-like atmosphere, as well as a safe and secure environment for everyone that participates in our ministries and uses our facilities.

Date ______Position applied for ______

Name ______Maiden ______

Address ______City/State/Zip ______

Home phone ( ) ______Cell phone ( ) ______

Current Driver’s License # ______State______SS# ______

(copy must be made of driver’s license) (copy of SS card, if available)

Are you legally eligible for employment in the U.S.? ______yes ______no

Note: If you are hired, you will be required to produce documents pertaining to your eligibility for employment in order to complete an I-9 Form.

Were you a victim of abuse or molestation as a minor or as an adult? ______yes ______no

(This question may be answered on this form and/or you may discuss your answer with a minister)

Have you ever been: (1) charged with any crime, (2) arrested for, (3) convicted of, or (4) pled guilty or nolo contendere or any offense involving, in any manner, a minor child or adult with special needs? ______no. If yes, please describe

______

(attach an additional page if necessary)

I have read the First Baptist Church of Shreveport “Because We Care” (for Children, Youth, and Adults with Special Needs) Protection Policies, fully agree to abide by same, and affirm that at no time in the past or present have I engaged in conduct that would fall within the definition of sexual abuse or neglect.

Signature Date

Page 2

Church History and Prior Ministry Experience

When did you make your public profession of faith in Christ? ______Date Baptized ______

Please explain your interest in working in the Children’s, Youth or Adults with Special Needs Ministry

______

______

Other than First Baptist Church of Shreveport, please list other churches you have attended regularly during the past five years.

Church’s Name/Complete Address Type of Work Performed Dates

______
______
______

List any gifts, callings, training, education, or other factors that have prepared you for this area of

ministry ______

______

Employment History (church employees only)

Current or Last Employer

Please complete all the following blanks about your employment history even if you do not think the questions relate to the position you seek.

Employer Name ______

Address ______

street city state zip code

Telephone # ( ) ______May we contact? ______yes ______no

Dates of employment: from ______to ______

Position or Title ______Starting Salary ______Ending Salary ______

(optional) (optional)

Name/Title of Supervisor ______

Describe job duties, responsibilities, and important accomplishments: ______

______

Reason for Leaving ______

Page 3

Next Previous Employer

Employer Name ______

Address ______

street city state zip code

Telephone # ( ) ______May we contact? ______yes ______no

Dates of employment: from ______to ______

Position or Title ______Starting Salary ______Ending Salary ______

(optional) (optional)

Name/Title of Supervisor ______

Describe job duties, responsibilities, and important accomplishments: ______

______

Reason for Leaving ______

Next Previous Employer

Employer Name ______

Address ______

street city state zip code

Telephone # ( ) ______May we contact? ______yes ______no

Dates of employment: from ______to ______

Position or Title ______Starting Salary ______Ending Salary ______

(optional) (optional)

Name/Title of Supervisor ______

Describe job duties, responsibilities, and important accomplishments: ______

______

Reason for Leaving ______

Educational Background

High School ______

College ______

Graduate ______

Other ______

Page 4

If you are presently enrolled in school, what are you studying? ______

List any special skills, training, or knowledge you have for this position and any other achievements you

would like considered. ______

______

References

If possible, list three business references who are not related to you and who were not your previous

supervisors. Otherwise, list three personal references who are not related to you.

Name Address City State/Zip Telephone Years known

1. ______

2. ______

3. ______

Applicant’s Statement

The information contained in this information/application form is correct to the best of my knowledge. I understand that this application may be withdrawn or my employment may be terminated if I have made

any misrepresentations on this form. I authorize First Baptist Church of Shreveport and its agents to contact any references or employers as listed on my information/application for employment form, to confirm the information supplied by me, and/or to obtain other material information (including opinions) about my qualifications and/or employment. I release First Baptist Church of Shreveport and its agents and all other persons, references, companies, or employers which provide information from any and all liability for providing or obtaining such information. I waive any right to view the material and references obtained in the screening process. Should my application be accepted, I agree to be bound by the policies of this church and to refrain from unbiblical conduct in the performance of my services on behalf of the church. I further state that I have carefully read the “Because We Care” Protection Policies. I understand the content thereof, and agree to be bound by same, and I sign this form as my own free act. I further agree to notify a minister and/or my supervisor and/or other agent of First Baptist Church of Shreveport if I am accused, arrested, convicted, or have pending charges of sexual abuse, physical abuse, or other sex-related offenses, neglect, or other crimes of violence after completing this application process. This is a legally binding agreement, which I have read and understand.

Signature ______Date ______

Revised 8/1/12