The Pentecostals of The Woodlands - Children's and Youth Worker's Application

This application is to be completed by all applicants for any position (volunteer or compensated) involving the supervision or custody of minors in any scheduled programs or activity of The Pentecostals of The Woodlands. It is being used to help provide a safe and secure environment for the children and youth who participate in our activities, as well as fulfill the church’s legal obligations. By completing and signing this application, you are affirming that your answers are truthful and accurate. If you do not wish to answer a particular question, or if you wish to discuss a question further, please talk to the pastor. The applications will be confidential and only be visible by the Senior and Executive Pastor.

Personal Information

First Name

Last Name

Phone Number

Email Address

Address 1

Address 2

Country

City

State

Zip/Postal Code

Date of Birth (i.e., mm/dd/yyyy)

Driver's License (The only individuals who will see this information is the Senior Pastor and Executive Pastor.)

State of Issuance of Driver's License

SSN (The only individuals who will see this information is the Senior Pastor and Executive Pastor.)

Church Background Information

Do you believe that the Bible standard of full salvation is repentance, baptism in water by immersion in the name of the Lord Jesus Christ for the remission of sins, and the baptism of the Holy Spirit with the initial sign of speaking with other tongues as the Spirit gives utterance? (See Acts 2:38.)
Yes
No

Have you received this experience?
Yes
No

When were baptized in Jesus' Name? (i.e., mm/dd/yyyy)

Where were you baptized and by who?

When did you receive the Holy Spirit with the sign of tongues? (i.e., mm/dd/yyyy)

Do you use tobacco, illegal drugs, or drink alcoholic beverages?
Yes
No

Have you ever been arrested, been convicted, or pleaded guilty to a crime?
Yes
No

If you have been arrested, been convicted, or pleaded guilty to a crime, please explain why. (please put "N/A" if this doesn't apply)

Has your driver’s license been suspended or revoked within the last seven years?
Yes
No

If your driver’s license has been suspended or revoked within the last seven years, please explain why. (please put "N/A" if this doesn't apply)

List (name and address) churches you have attended during the past five years.

List all previous work involving youth (list each organization’s or church’s name; type of work, and dates).

Disclosure Agreement

You have my permission to obtain a background check of my personal record. In addition, I authorize any references or churches listed in this application to give you any information (including opinions) that they have regarding my character and fitness for working with children and youth. I agree to live by the understanding that, as a person in authority, it is my responsibility to avoid sexual contact with children and/or youth, even if they attempt to initiate contact. I will find alternative ways to discipline, agreeing that under no circumstance will I use any form of corporal punishment (spanking, neck or choke holds, ear or hair pulling, etc.) as a means of discipline. I certify that the information I have provided is true and correct. If it is found that the answers given are untrue, I understand it may be cause for dismissal.

I agree to abide by all of the church’s written policies regarding children and youth.
Yes
No

I agree and consent to The Pentecostals of The Woodlands conducting a mandatory state and national background check.
Yes
No

Please initial your first and last name below as a sign of agreement.

Children and Youth Worker Application

Children and Youth Worker Application

Personal Information

Church Background Information

Disclosure Agreement

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