Servant Application

Name*

First Middle Last

For what ministry/program are you applying to serve?*

Vacation Bible School
AWANA Club
Sunday Morning Children's Ministry

Are you currently...*

18 or older
Younger than 18

Social Security Number*

Social Security Number is is required for anyone over the age of 18 applying to serve in our children's ministries. Please contact our Children's Ministry team if you prefer a paper application.

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Cell Phone*

Email*

Date of Birth*

What church are you a member of?*

Church phone number*

Church Positions (paid or volunteer) held in the past?*

List any previous non-church work (paid or volunteer) involving children/young adults.*

Current Employer’s Name and phone number*

Have you ever been convicted, pled guilty, or pled (no contest) to any criminal offense other than a minor traffic violation?*

Yes
No

If yes, please explain below

Are you currently under investigation or named in an indictment, accusation or special presentment of any offense other than a minor traffic violation?*

Yes
No

If yes, please explain below

Have you ever been convicted of child abuse or sexual abuse; been involved in any activities related to child pornography, molesting or abusing children/youth; or been investigated based on a report of child abuse/neglect or suspected child abuse/neglect?*

Yes
No

If yes, please explain below

Application Statement*

I affirm that the information contained in this application is correct to the best of my knowledge; I authorize Lynn Haven United Methodist Church to conduct a Background Investigation; Should my application be accepted, I agree to be bound by the bylaws and policies of LHUMC (as found in the Education Department Statement of Faith) and the departments applicable to my service and will refrain from unscriptural conduct in the performance of my services on behalf of the LHUMC; I agree that I have read and understand the above acknowledgment and agreements and recognize all of the above as conditions of my service to Lynn Haven United Methodist Church.

Electronic signature*

Please type full legal name