UMCNB Children & Youth Ministry Volunteer Application

The information obtained on this form is for internal use by the United Methodist Church at New Brunswick (UMCNB) only.

SECTION 1: PERSONAL INFORMATION

Name

Date of Birth

Address

Phone

This address will receive a confirmation email

SECTION 2: REQUIREMENTS

To volunteer with our ministry a background check, including a motor vehicle report (if applicable) and Safe Sanctuary training (including sexual abuse training) is required.

Other trainings may be requested during the year. All required and requested trainings are offered for free.

Background Check:
If I do not have a recent one on file for you (within the last 2 years), another email with a link to complete one will be sent to the email address provided above.

Safe Sanctuary Policy:
In accordance with the requirements of the Greater New Jersey Annual Conference of the United Methodist Church (GNJAC), and with the assistance of materials provided by the GNJAC, The United Methodist Church at New Brunswick (UMCNB) has developed policies which shall apply to all programs dealing with children, youth under age eighteen (18), and vulnerable adults. This policy is reviewed during training(s) and as needed.

SECTION 3: CHURCH ACTIVITY

Member or Regular Attendee of UMCNB for six (6) months or more?

Yes (move onto Section 4) No (List names of other churches you've attended regularly in the past six (6) months below)

(Church Name, Pastor's Name, Months/Years Attended)

SECTION 4: REFERENCES

Please provide atleast two (2) independent references (Not relatives)

Name

Relationship

City & State

Phone

Name

Relationship

City & State

Phone

SECTION 5: HISTORY

Have you ever been convicted of any criminal offense?

Yes No

Have you ever been charged with or convicted of child neglect or abuse?

Yes No

Have any complaints or allegations of misconduct involving children ever been made against you?

Yes No

Have you been convicted of the possession, use, or sale of drugs?

Yes No

Within the past 30 days have you abused alcohol, legal or illegal drugs?

Yes No

Have you been convicted or plead guilty to a traffic offense within the last 5 years?

Yes No

Current Driver's License Number:

SECTION 6: HISTORY EXPLANATION

Please explain fully any YES answers to the above questions in Section 5.

In addition to the above, is there any fact or circumstance involving you or your background that would call into question your being entrusted with the supervision, guidance, and care of young people?

SECTION 7: CERTIFICATIONS

Please Select if You Have the Below Certifications:

CPR First Aid Other (List Below) None

Please Attach Copy of Certification Here:

Upload (8MB)

Please Attach Copy of Certification Here:

Upload (8MB)

Please Attach Copy of Certification Here:

Upload (8MB)

SECTION 8: VOLUNTEER INTEREST

How Would You Like to Serve?

Sunday School (Preschool - 1st) Sunday School (2nd - 5th)) Youth Group (6th - 12th) Monthly Events/Trips Mission Trips/Retreats Teach a Skill or Trade Transportation Wherever You Need Me!

If selected "Trade or Skill," please indicate here

The information that I have provided may be verified by contacting persons or organizations that may have information concerning me. I authorize a background check to be conducted. I hereby release and agree to hold harmless from liability any person or organization that provides information, and this release may be sent to any reference. I also agree to hold harmless the United Methodist Church at New Brunswick, and the officers, employees, and volunteers thereof from any use of this application or information. I waive any right that I may have to inspect references provided on my behalf. I certify that the information I have provided is true and correct; if it is found that the answers given are untrue, I understand it may be cause for dismissal. By signing below I agree understand and agree to all above.

By typing my name below, I agree and understand that any typed signature is considered the same as providing a manual or handwritten signature and is equally binding.

Signature

Date (mm/dd/yyyy)

UMCNB Children & Youth Ministry Volunteer Application

Description

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