FirstChurch of the Nazarene of Pasadena

Volunteer Application

Name: / Today’s Date:

Current/Previous Church Attendance

List any churches you have attended regularly over the past seven years. Use additional pages to list more churches if needed.

Church Name: Church Name:

Phone Number: ( ) Phone Number: ( )

Pastor: Pastor:

Dates Attended: Dates Attended:

Do you attend and/or serve regularly?  Yes  NoWere you attending and/or serving regularly?  Yes  No

Previous Ministry Experience

Have you volunteered in a church before?If so, please describe your area of service.

Position: Dates Served: Church Name:

Reported to:

Please describe your relationship with Christ and your spiritual beliefs.

Describe your 3 greatest strengths.(What are you good at? What energizes you?)

Describe 3 of your weaknesses.(What aren’t you good at? What drains you?)

REFERENCE INFORMATION

Reference information will be used for purposes of validating information provided in volunteer application. Information received through references and background check will be used to determine ability/safety for working with children, elderly and the disabled. Any additional information not needed to asses before issues will be held in strict confidence and only viewed by the head of Human Resources, Executive Pastoral Staff and appropriate Ministry Director.

Please provide two references: One from a Pastor and second from a co-worker or friend.

1.______Email address:______

2.______Email address:______

Release of Liability and Photo Release

______I release FirstChurch of the Nazarene of Pasadena, its employees, and other volunteers from all actions, damages, or personal injuries which may occur. I understand that in the event of a minor injury, I may receive first aid treatment. If my personal judgment is hindered due to an emergency, injury, or illness, I authorize FirstChurch of the Nazarene of Pasadena to take whatever action is necessary for my personal safety and health.

______Igive my consent that photographs, interviews, and audio/video recordings during the course of any ministry activity may be used by FirstChurch of the Nazarene for training, promotion and fundraising.

______I the undersigned applicant (also known as consumer), authorize FirstChurch of the Nazarene of Pasadena through its independent contractor, LexisNexis, to procure background information (also known as a “consumer report and/or investigative consumer report”) about me. This report may include my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history/records; and the state sex offender records. This report is to provide clearance to work with children and adults who have special needs.

______I understand that I am entitled to a complete copy of any background information report of which I am the subject upon my request to FirstChurch of the Nazarene of Pasadena, if such is made within a reasonable time from the date it was produced. I also understand that I may receive a written summary of my rights under the Fair Credit Reporting Act.

I also to hereby authorize FirstChurch’s Special Needs Ministry to contact any references listed herein. I release all references and prior employers from any liability for information.

Signature / Date / Signature of parent/guardian (if under18)

Email:______Cell phone number:______

FirstChurch of the Nazarene of Pasadena

Permission to Obtain a Background Check

(This form authorizes the church to obtain background information and must be completed by the applicant.

The church must keep this completed form on file for at least two years after requesting a background check.)

I, the undersigned applicant (also known as “consumer”), authorizeFirstChurch of the Nazarene of Pasadenathrough its independent contractor, LexisNexis, to procure background information (also known as a “consumer report and/or investigative consumer report”) about me. This report may include my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history/records; and the state sex offender records.

I understand that I am entitled to a complete copy of any background information report of which I am the subject upon my request to FirstChurch of the Nazarene of Pasadena, if such is made within a reasonable time from the date it was produced. I also understand that I may receive a written summary of my rights under the Fair Credit Reporting Act.

Signature: ______Date: ______

Identifying Information for Background Information Agency

(also known as “Consumer Reporting Agency”)

Print Name: ______

FirstMiddleLast

Other Names used (alias, maiden, nickname): ______

Current Address: ______

Street /P. O. Box CityStateZip CodeCounty Dates

Former Address: ______

Street /P. O. BoxCityStateZip CodeCountyDates

Social Security Number: ______Daytime Telephone Number: ______

Driver’s License Number: ______State of Issuance: ____ Date of Birth: ______Gender______