If you only need to complete the screening form check 'references & screening form' otherwise you will be directed to complete the entire application, references & screening form* Application, References & Screening Form References & Screening Form

	General Information
	Name* First Name Last Name
	Month   Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day   01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year   2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
	Address* City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State Zip Code
	Email*
	Myspace/Facebook/Twitter
	Date of Birth* MM/DD/YYYY
	Home Phone
	Cell Phone
	Occupation
	Employer
	Work Status* Part Time Full Time Student Unemployed
	Marital Status* Single Married Divorced

	Education
	High School
	Year Graduated
	College / Trade School
	Year Graduated
	Degree
	Minor
	Other Education
	Year Graduated
	Hobbies and Interests

	Personal References
	REFERENCE #1 (No relatives OR current or former employers)
	First Name, Last Name
	Address
	Email
	Phone
	REFERENCE #2 (No relatives OR current or former employers)
	First Name, Last Name
	Address
	Email
	Phone

	Personal and Spiritual History
	Have you ever been batized in water?* Yes No
	Write a brief testimony about how you became a Christian (include date).
	Write briefly about significant events in your life that have impacted you spiritually.
	Describe three major ways in which you have grown in your spiritual journey since you became a Christian.
	How would you describe your spiritual journey now?
	What accountability do you currently have in your spiritual journey?
	What do you do when you have a conflict with someone? Would you consider yourself “good” at handling confrontation? How do you handle confrontation?
	Are there any special issues or concerns happening in your life right now that would have an impact in your commitment and involvement in the youth ministry? (e.g. relationships, other commitments, etc.)

	Legal and Lifestyle Concerns In caring for students, we believe it is our responsibility to seek an adult staff that is able to provide healthy, safe, and nurturing relationships. Please answer the following questions accordingly. Any special concerns can be discussed individually, l with the pastoral staff.
	Are you using illegal drugs* Yes No
	Have you ever gone through treatment for alcohol or drug abuse?* Yes No
	Please explain...
	What is your view on drinking alcohol?*
	Have you ever been arrested or convicted of a crime?* Yes No
	Please explain...
	Have you ever had sexual relations with a minor after you became an adult?* Yes No
	Have you ever been accused or convicted of any form of child abuse?* Yes No
	Please explain...
	Have you ever been a victim of any form of child abuse?* Yes No
	Would you like to speak to a counselor or pastor? Yes No

	Ministry
	How long have you attended SouthLake?
	How often do you attend church?
	Describe any other ministry / church experience you have been involved with
	What spiritual gifts do you feel you have, and how would you like to use them in youth ministry?
	Why do you want to do youth ministry?
	What are some of your expectations of the youth ministry staff?

	Volunteer Staff Commitment
	I acknowledge the Lordship of Jesus Christ in my life and I have a personal relationship with Him.* I agree
	I am committed toward growing and maturing in my relationship with God through quiet times, active attendance at church, and involvement in accountability.* I agree
	I am committed to choices and a lifestyle that are both Godly and "above reproach", knowing that my lifestyle is a model for the students.* I agree
	If at any time I am not being a good lifestyle model I will talk to my leaders. * I agree
	I am making a commitment to BEYOND for at least the rest of the semester.* I agree
	I will attend leader meetings.* I agree
	I will make a committed attempt to help recruit at least one other volunteer for our growing needs in BEYOND.* I agree
	I understand the philosophy of this youth ministry and agree with its purpose and commit to shepherding students that God brings to me. * I agree
	I will check my e-mail at least once a week since this is an important way of communication and so that I will be informed.* I agree
	Because I am making a significant commitment and my presence is important, I agree to be consistent and timely to the program(s) I commit myself to (at least 10 minutes early to Sunday mornings, 15 to small groups, etc.). * I agree
	I am making a commitment to at least one of the following* Weekend Services Small Groups Special Events Ministry Team Coordinator
	Enter the name of the ministry you will be coordinating

	Criminal Record Check
	Have you ever been convicted of, adjudicated in juvenile court for, or plead guilty to a crime?* Yes No
	If yes, please explain below
	I hereby authorize SouthLake Foursquare Church to obtain information pertaining to any charges and/or convictions I may have had for federal and state criminal law violations. This information will include but not be limited to allegations and convictions for crimes committed upon minors and will be gathered from any law-enforcement agency of this state or any state or federal government, to the extent permitted by state and federal law. I hereby release said law-enforcement agency from any and all liability resulting from such disclosure. * I agree
	Full Legal Name*
	Maiden Name and All Aliaes Applicable
	Date of Birth* MM/DD/YYYY
	Place of Birth*
	Drivers License Number (with State)*
	Comments
	The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children work. In consideration of the receipt and evaluation of this application by SouthLake Foursquare Church, I hereby release an individual, church, youth organization, charity, employer, reference, or any other person or organization, including reccord custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. Should my application be accepted, I agree to be bound by the Bylaws and policies of SouthLake Foursquare Church and to refrain from unscriptural conduct in the performance of my services on behalf of the church. I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act. This is a legally binding agreement which I have read and understand. * I agree