Texas Southeast First Ecclesiastical Jurisdiction

TEXAS SOUTHEAST FIRST ECCLESIASTICAL JURISDICTION

ACKNOWLEDGEMENT OF SEXUAL MISCONDUCT POLICY

I, ______, as a candidate for credentials in Texas Southeast First Ecclesiastical Jurisdiction, agree to observe all church policies and procedures while working with youth or children or adults in any capacity.

I understand that Texas Southeast First Ecclesiastical Jurisdiction prohibits sexual misconduct, sexual coercion and /or sexual exploitation of children or adults while I minister or conduct missionary duties in any internal or external activity related to the church.

I understand that if I engage in such behavior I will be subject to appropriate discipline that may include civil and/or criminal action(s).

I agree to fully cooperate with the church by complying with the church’s policies and procedures.

I acknowledge that disciplinary action(s) may result in termination of my work as a credential holder in Texas Southeast First Ecclesiastical Jurisdiction.

I acknowledge that I understand the church’s policy on sexual misconduct and agree to abide by it.

Signature of Candidate ______

Printed Name of Candidate ______

Date ______

1. List any denominations or churches of which you have been a member, including the city and state.

List all previous church service, volunteer or paid, you have provided for the last 10 years, and any special gifts and talents. Include approximate dates. Attach a separate page, if necessary)

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2. List all your (non-church) previous employers, include approximate date, organization’s name and address, type of work you performed, name of supervisor and phone number. (Attach a separate page, if necessary)

Date: Organization: Type of Degree: Phone #:

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3. List your highest earned academic degree (and/or professional license). Include date, organization’s name and address, type of degree (license), and phone number.

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4. Please provide the names and phone numbers of three personal references not related to you.

Name: Home Phone: Work Phone:

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5. Because Texas Southeast First Ecclesiastical Jurisdiction cares for all persons on our campuses (churches), we ask you to please answer the following questions. We understand the following questions are personal and we will protect your privacy.

a. Have you ever been charged with or committed a crime (regardless of age), including criminal traffic violations? Yes ______No______if yes, please explain: (attach a separate page if necessary)

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