Volunteer Staff Application

Check all that apply

Date

Have you ever been convicted of, or pleaded guilty to, or are there charges pending concerning, any crime or misdemeanor involving actual or attempted child abuse or neglect or sexual molestation, including but not limited to, murder, abduction for immoral purposes, sexual assault, failing to secure medical attention for an injured child, pandering, crimes against nature involving children, taken indecent liberties with children, neglect of children, obscenity offenses, or similar moral impropriety involving children?

Have you ever been subjected to disciplinary action, suspended, terminated, or asked to leave a job or volunteer position because of engagement in child sexual abuse or neglect, other unlawful sexual behavior, or otherwise violating an employer’s sexual misconduct or harassment policy?

Education and Employment

References

Please provide a non-family reference for each category below who you are comfortable with us contacting. We recommend having your personal references be mature believers who know you well and/or if they can speak to your performance in a work setting. Please notify your references that they have been listed and will be contacted.

Spiritual Life

Acknowlegement

I feel the liberty of the Holy Spirit to fill out this application to serve in the area of children and youth ministry with Jews for Jesus, and affirm that the information I am providing in this application is true. I understand that making any misleading or untruthful statement on this application can result in my dismissal and bar further consideration for service. I hereby authorize Jews for Jesus to thoroughly investigate my criminal history, references, work record, education and other matters related to my service and release Jews for Jesus and all others from liability in connection with same.

*For minors - Additional consent from parents will be obtained

Please check the box "I understand" below if you have read and agree to the above statement.
Date

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