Campus Page

Name

Address

City

State

Zip

Home Phone

Cell Phone

E-mail

Marital Status Single Married Divorced

Spouses Name (if applicable)

Briefly describe when and how you became a Christian.

Have you been baptized by immersion? If so, when?

How is God working in your life now?

In what ways has God used your gifts, talents, and abilities to bring glory to Himself?

Is there anything else you feel that we need to know about you? If yes, please explain.

Do you know your spiritual gifts? If yes, what are they?

Please list all churches and cities where you have regularly attended in the past five years.

Please list the dates and activities of other ministry experience that you have been involved in here at SCC.

How long have you been regularly attending SCC?

Are you a member of SCC?
No
Yes

List all previous work (church and non-church) involving children and/or youth. Please include each organization’s name and contact information.

List the reason why you would like to serve in children’s ministry.

Have you ever been arrested, convicted of, or pled guilty to a felony offense of any kind?
No
Yes

Have you ever been arrested or convicted of any offence involving any crime of violence including domestic violence?
No
Yes

Have you at any time within the past three years abused prescription drugs or used illegal drugs, including marijuana?
No
Yes

Is there any circumstance or pattern in your life which would make it inappropriate for you to serve with minors?
No
Yes

Do you have any health issues that could put you or others at risk by serving in ministry?
No
Yes

If you answered ‘yes’ in any of the above questions, please explain.

Reference 1 Name

Reference 1 Phone

Reference 1 E-mail

Reference 2 Name

Reference 2 Phone

Reference 2 E-mail

Reference 3 Name

Reference 3 Phone

Reference 3 E-mail