Knox Church -Safety Team Volunteer Application

Knox Safety Team Volunteer Application

First name *

Last name *

Current occupation

Address *

Country

City

Zip code

Email *

Preferred phone number *

Preferred phone type *

Home Phone

Mobile Phone

Office Phone

Alternate phone number

Alternate phone type

Home Phone

Mobile Phone

Office Phone

Knox Member *

Yes

No

Attending Knox since (month-year):

Have you served in other ministries at Knox?

Yes

No

If so, what was your experience?

If you continue to serve in that ministry, does it conflict with being on the Safety Team?

Yes

No

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 attended

Questions

Why would you like to serve on the Safety Team? *

Are you able to commit to one Sunday a month?

We recognize there are times when people need to be gone due to conflicts—vacations, illness, etc.

Yes

No

Would you be able to be at church from 8:30 AM - 12:30 PM on your designated Sunday?

Yes

No

If you are married, does your spouse support your participation on the Safety Team?

Yes

No

What qualities or skills do you have that would help you work with the public? *

Do you have any special safety training or credentials that might support your participation on the Safety Team?

Yes

No

If yes, please describe:

What safety or security related work or volunteer experience do you have, if any?

Do you have any disabilities or conditions which would prevent you from carrying out safety-related duties, such as lifting or running? *

Yes

No

If yes, please explain:

References

Instructions

Please provide three references (other than relatives) and their contact information. One reference should be someone who is not connected with Knox Church.

Name of reference #1 *

Email or street address of reference #1 *

Phone number of reference #1

Name of reference #2 *

Email or street address of reference #2 *

Phone number of reference #2

Name of reference #3 *

Email or street address of reference #3 *

Phone number of reference #3

Reference disclosure

I 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 agree

I do not agree

Applicant Agreement

I 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 agree

I do not agree

If there are any changes in the above information, the volunteer should inform the Safety Team Director.

All applicants must complete a Knox Applicant Release and Agreement Form. If you have not completed this form in the past three years, please download and complete the form, and place in a sealed envelope in the Safety Team mailbox in the lower level workroom. For prompt processing of your application, please complete this form within two weeks of applying.

After submitting this application you will be automatically redirected to the Applicant Release and Agreement Form.

Thank you for your interest in the Knox Safety Team!

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