Children’s Ministry Adult Volunteer Application If you are human, leave this field blank.Part 1 of 3, of the Children's Ministry Volunteer application processFirst Name *Last Name *Address *Apt, suite, etc.CountryUnited States (US)United Kingdom (UK)CanadaAustralia---AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabweCityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)American SamoaGuamNorthern Mariana IslandsPuerto RicoUS Minor Outlying IslandsUS Virgin IslandsZip codeEmail *Preferred phone contact *Preferred phone contact type *Home PhoneMobile PhoneOffice PhoneAlternate phone contactAlternate phone contact typeHome PhoneMobile PhoneOffice PhoneKnox Member *YesNoAttending Knox since (month-year):Please note other church(es) you have attended in the past 5 years? (if applicable)Please list: Church name, pastor's name and # of years attendedIn what area(s) are you volunteering to serve? *Please check all that applyEarly Childhood Program (Nursery, Toddler 1, 2, 3)Elementary Christian EducationChildren’s Worship (Prek/K, 1-3rd)Kids’ Club (Wed evenings, Prek-6th)Kids’ Camp (Summer, Prek-6th)OtherPlease note "Other" areaQuestionsWhy would you like to serve in Children’s Ministry? *What qualities or skills do you have that would help you work with children? *Do you have any disabilities or conditions, which would prevent you from performing certain types of activities relating to children’s work? *YesNoIf yes, please explain:What prior experience working with children do you have?Experience working with children #1 *Note: Organization, Program, Dates & Contact PersonDo you have 2nd experience to add? *YesNoExperience working with children #2Note: Organization, Program, Dates & Contact PersonDo you have a 3rd experience to add?YesNoExperience working with children #3Note: Organization, Program, Dates & Contact Person ReferencesInstructionsPlease provide two references (other than relatives) and their contact information Name of reference #1 *Contact info of reference #1 *Email or street addressName of reference #2 *Contact info of reference #2 *Email or street addressReference disclosureI understand that any release/disclosure of information carries with it the potential for an unauthorized redisclosure and the information may not be protected by Federal Confidentiality Laws. I understand that I have waived my right to inspect any information provided by my references and have released all individuals and organizations from any and all liability for damages in regard to their release of information about me. Agreement to reference disclosure *I agreeI do not agree Applicant AgreementI certify that the information I have provided in this application is correct to the best of my knowledge. I understand that this application will be kept strictly confidential. Applicant Agreement *I agreeI do not agreeThis application remains in effect even if the volunteer changes their area of service. If there are any changes in the above information, the volunteer should inform the Children’s Ministry Director. Captcha *reCAPTCHA is required.Submit
