Youth Ministry Volunteer Application

This application is to be completed by applicants for Youth Ministry positions. It will be used to assist Door of Hope in providing a safe and secure environment for the children who participate in our program and who use our facilities. Please fill out the entire form. Upon completion, the form will be submitted to the Pastor of Youth Ministry. Please email tsion@doorofhopepdx.org if you would prefer to fill out a paper application.

Your name *

Last name

Email address *

Birthday

Address

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Phone number

Phone type

How long have you attended Door of Hope? *

Have you had the opportunity to work with middle and high school students before, either as a volunteer or an employee? *

Yes

What is your current place of employment? *

Do you have skills or experience that relates to Youth Ministry? *

Safety Screening

We must ask the following questions to be sure we provide the children with the utmost safe and secure environment.

Have you ever been charged with or convicted of a crime? *

Yes

Have you ever been arrested for any reason? *

Yes

Have you ever engaged in, or been accused of, any injury, molestation, abuse or exploitation of a child? *

Yes

Do you have any tendency, trait, condition, or past conduct that could be considered dangerous or a threat to any person? *

Yes

Is there any reason why you possibly should not be working with youth or children?

Yes

If any of your answers to the questions in this section change while working or volunteering at Door of Hope, you must notify us immediately. This includes any new arrest, charge, or accusation. *

I agree

I do not agree

References

Please list three people who know you well and who would recommend you for ministry with children. At least one reference must attend Door of Hope (no relatives or spouses please).

Name of reference 1: *

Phone number *

Phone type

Email Address: *

Name of reference 2: *

Phone number *

Phone type

Email Address: *

Name of reference 3: *

Phone number *

Phone type

Email Address: *

Criminal History Authorization

In order to protect the children who attend Door of Hope, the staff requires the name of every new volunteer in the Youth Ministry to undergo a criminal background check. Information provided by this check will not necessarily disqualify a candidate from serving in the Youth Ministry. However, the prospective volunteer will not be allowed to serve in the Youth Ministry until the background check is completed. All information received will be kept in such a manner that will only be available to the Door of Hope staff.

Maiden Name (if applicable)

Alias or Former Names (if any):

Verification and Release

I recognize that Door of Hope is relying on the accuracy of the information I provided above. Accordingly, I attest and affirm that the information I have provided is absolutely true and correct.

I authorize Door of Hope and its representatives to contact any person or entity listed on the application form, and I further authorize any such person or entity to provide the organization with information, opinions, and impressions relating to my background or qualifications.

I voluntarily release Door of Hope, its representatives, and any person or entity listed on this form from liability involving the communication of information relating to my background or qualifications. I further authorize the organization to conduct a criminal background investigation.

By my signature below, I hereby authorize Criminal Informational Services, Inc. (CRIS) to release any information, which pertains to any record of conviction, in its files or in any criminal file maintained on me whether local, state, or national. I hereby release CRIS and Door of Hope from any liability resulting from such a disclosure.

I understand that I may obtain a copy of the Criminal History Report and will be given the opportunity to challenge the accuracy and completeness of this report and obtain a prompt determination as to the validity of the challenge before a final determination is made by Door of Hope.

By checking this box and typing my name below, I am electronically signing my application. *

Signature *

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Door of Hope
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