Name *

First Name

Last Name

Phone Number *

(###)

###

####

What is the best way to reach you? *

Email

Phone

Have you been baptized? *

Yes

No

Do you have any medical conditions that would affect your ability to serve? *

Yes

No

Have you ever or do you currently struggle with alcohol or substance abuse? *

Yes

No

Have you ever been hospitalized, treated, or are currently taking medication for mental illness? *

Yes

No

Have you ever been convicted of a felony? *

Yes

No

Have you ever been arrested, charged, or convicted for any physical/sexual abuse of a minor or an adult? *

Yes

No

Have you ever been asked to leave a fellowship or resign from any position due to inappropriate behavior? *

Yes

No

Which ministry or ministries are you interested in serving in? *

*Children and Student Ministries have specific requirements

Ushering

Greeting - Hospitality

Coffee - Hospitality

Media Team

Tech Team

Worship

Children's Ministries *

Student Ministries *

Date *

MM

DD

YYYY