updated Youth Volunteer form If you are human, leave this field blank.The information on this form is to be viewed by the Youth Ministry and the relevant office staff only.First Name *Last Name *Date of Birth *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 codeHome PhoneCell Phone *Email *Which do you prefer we use to contact you? *Home PhoneCell PhoneEmailSpouse Name (if married)Children and Ages (if applicable)Are your children involved in the youth ministry?YesNoOccupation and EmployerWork StatusPart-timeFull-timeStudentKnox MemberYesNoAttended Knox for more than 5 years?YesNoAttending Knox since (month-year):Please note other church(es) you have attended in the past 5 yearsPlease list: Church Name, Pastor's Name & Years AttendedConfidentiality *It should be understood that submitting personal information over the internet carries with it a certain level of access to sensitive information. We do our best to keep this information for youth ministry staff only, but if you would prefer to submit the answers to the following questions in paper form please check the appropriate box.I would prefer to submit a confidential paper response to questions.I would prefer to complete the application online.We will send you an email with questions attached. Please submit as soon as you are able.QuestionsIn what capacity have you volunteered with youth in the past? *Why would you like to serve in the Youth Ministry? *What qualities, knowledge, or skills do you have that would help you/us work with youth? *Do you have any disabilities or conditions which would prevent you from performing certain types of activities relating to youth work? *YesNoIf yes, please explain:Have you ever participated in a small group? *YesNoIf yes, please describe your experience and how it impacted you:What are you currently doing to grow in your relationship with the Lord? *Would you share briefly how you became a Christian and how Christ is currently working in your life? * ReferencesPlease list two non-related individuals who would be able to give an objective evaluation of your character and capabilities. Reference 1 *Please include: name, phone, address, email, your relationship to the reference and how long you've known them.Reference 2 *Please include: name, phone, address, email, your relationship to the reference and how long you've known them.Reference disclosureI authorize references from individuals listed in this application to give Knox Presbyterian Church any information including opinions they may have regarding my character and fitness for work with minors. I release individuals and organizations that provide any information about me from any and all liability for damages of whatever kind or nature in regard to their release of information. I waive any right I may have to inspect any information provided about me by those identified on this application. A copy of this release may be sent to any of the references I have supplied.I agreeI do not agreeApplicant agreementI 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. 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.I agreeI do not agreeSignatureReset SignatureThis 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 Youth Ministry Director. 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