Staff/Volunteer Application Packet

CHILDREN AND YOUTHMINISTRIESFIRST UNITED METHODISTCHURCH COPPELL

First United Methodist Church Coppell
Ministry Safe Staff/Volunteer
Application FormConfidential
This application should be completed by all applicants for any staff/volunteer position
involving the supervision of minor children, youth or vulnerable adults. This is not
an employment application. The purpose of this form is to assist in the creation of asafe environment for children, students and vulnerable adults who participate in theprograms of First United Methodist Church Coppell or use of its facilities.
Name:Address:

Phone: __________________________

Staff/Volunteer in ____________________Ministry

Email Address _____________________________________ Date of Birth ________________
Marital Status: ______ (single, married, separated, divorced, widowed, etc.) Sex _____ M _____ F
Are you a member or regular attender of this church?

If so, for how long?

How long have you lived at your current address?
Previous address:______________________________________________________________________________________________

Please list the name, address, city and state of other churches you have attended regularly
during the past 10 years:

Ministry Safe Staff/Volunteer Application

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Please list all previous church work involving children, students or vulnerable populations(impaired, adults, special needs individuals etc.). (List each church’s name and address, typeof work carried out, dates, and a contact person familiar with your work there. Use backof this page for more space, if necessary.)

Please list all previous non-church work involving children, students or vulnerable
populations. (List each organization’s name and address, type of work carried out, dates and acontact person familiar with your work there.)

List any talents, vocations, preparation, training or other experiences which have equipped
you to work with children, students or vulnerable adults:

Please list three persons/references, other than relatives, who have knowledge of yourwork with children, students or vulnerable adults. Please provide name and emailaddress.

_____________________________________________________________________________

Ministry Safe Staff/Volunteer Application

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Why do you want to work with children, students or vulnerable adults at First United
Methodist Church?

Do you have a preference concerning the age group or sex of children or students withwhom you would like to work? Why?

What is your philosophy concerning re-direction or discipline of children?

RELEASEI authorize First United Methodist Church Coppell to contact all individuals,organizations and references listed on this Ministry Safe Staff/Volunteer Application
Form in order to verify the information I have provided to the church. I agree to releasefrom liability any person or organization that provides information concerning me,
including those persons I have listed as references, as well as contact persons from myprevious church and non-church work, listed on this application.
I specifically authorize the church to undertake a criminal background check concerning
my past.
I understand and agree that any information received from the background check andapplication verification will not be disclosed to me, and I hereby waive any right I may
have to inspect any information provided about me by any person or organization identified
by me on this form.
By signing this form, I certify and affirm that the information I have given on this form
is true, complete and correct in all respects.

Staff/Volunteer Signature:

Ministry Safe Staff/Volunteer Application

Date:

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Staff/Volunteer Statements and Agreed Code of Conduct
Please initial each of the following statements:
I declare that all statements contained in my Application Form are true. I understandthat any misrepresentation or omission is cause for dismissal from any ministry
involvement.
I understand that my references and contacts from prior church or non-church work withchildren, student, or vulnerable adults will be contacted and that an appropriate
criminal background check will be conducted. I authorize investigations of all statements
contained in this application. I specifically authorize the church to undertake a criminal
background check of my past.
I understand that I must be interviewed and recommended by a member of the First UnitedMethodist Church Coppell Screening and Selection Committee before I begin service asa staff/volunteer in First United Methodist Church ministries.
I understand that I can withdraw from the application process at any time.
I understand that First United Methodist Church Coppell has a policy of ZEROTOLERANCE FOR ABUSE and takes all allegations of abuse seriously. I furtherunderstand that First United Methodist Church Coppell cooperates fully with theauthorities to investigate all cases of alleged abuse. Abuse of any kind is grounds for
immediate dismissal from my staff/volunteer position and possible criminal charges.
I declare that I am not a pedophile or child molester. I have not perpetrated physical abuse,sexual abuse, emotional abuse or neglect against a child, student or vulnerable adult, andI have never been accused of these acts.
I understand and agree that false statements regarding past conduct and/or present
situations may be grounds for denial of this application to provide volunteer services,and that refusal to inform First United Methodist Church Coppell of the contents of asealed criminal record will result in the automatic denial of the application.
_____ If accepted as a volunteer, I agree to read and abide by all Policies and Procedures provided tome by First United Methodist Church Coppell.
Staff/Volunteer Signature:Date:

I have reviewed this application and have noted any missing information.
Ministry Safe Representative: ____________________________ Date:

Ministry Safe Staff/Volunteer Application_____________________

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APPENDIX I
MinistrySafe Exceptions

MinistrySafe Exceptions FUMCAll FUMC Staff must complete MinistrySafe training and certification.
All Volunteers working with children and youth must complete MinistrySafe training and certification.
All Stringfellow Staff must complete MinistrySafe training and certification.
All Stringfellow volunteers working with children must complete MinistrySafe training and certification.
All Sanctioned FUMC para-church ministries (i.e. Boy Scouts, American Heritage Girls-FUMC charteredgroups) must annually provide a complete list of all volunteers compliant with their respective Safety
Policies or complete MinistrySafe training and certification.

Exceptions:
1. Special guest for children and youth activities must be supervised by a MinistrySafe
Certified staff member or volunteer.
Example: Speakers, entertainers, performers - one-time events.
2. Adults with their children attend a children or youth event, but not in a volunteer capacity.
Example: Parent(s) attending Easter egg hunt with child.
3. Other adult volunteers who do not directly work with children or youth.
Examples: Usher, sound tech, video tech…
4. All volunteers who have not been a member of FUMC Coppell for six months; volunteer participationmust be verified by another faith based organization or entity by FUMC Staff.