Howe Methodist Nursery Worker Employment Application

Your name *

Email address *

Phone number *

Phone number

Address *

Birthdate *

Occupation *

Please list your current occupation.

Employer *

Please list your current or last employer and their contact information.

Work *

Full Time

Part Time

Student

Other

Previous Experience

Please list any previous ministry or childcare experience: *

What gifts are you hoping to use in working with children? *

Church Attendance

Do you attend Howe Methodist Church? *

Yes

Please write a brief history of your relationship with Jesus. *

References

Please provide two or more character references who know you well and are unrelated to you.

Reference #1 *

Please list the following information:
- Name
- Phone Number
- Email
- Nature and Length of Relationship

Reference #2 *

Please list the following information:
- Name
- Phone Number
- Email
- Nature and Length of Relationship

Reference #3

Please list the following information:
- Name
- Phone Number
- Email
- Nature and Length of Relationship

Code of Conduct Agreement

Please initial and answer the following fields to acknowledge that you agree with each statement.

I desire to share the love of Jesus in all my behavior, especially as I care for children during any activity sponsored by Howe Methodist Church. *

Please initial

I will aim to demonstrate my love for the Lord Jesus, my gratitude for His grace and forgiveness, and testify to the power of the Holy Spirit working in my life. *

Please initial

I desire to demonstrate respect, loyalty, patience, courtesy, and maturity. *

Please initial

I will treat all children with respect and consideration. *

Please initial

I will not abuse children/youth, in any way, including but not limited to: *

1. Physical abuse (ex: strike, shake, slap)
2. Verbal/Mental abuse (ex: humiliate, degrade, threaten)
3. Sexual abuse (ex: inappropriate touch or exposure)

Please initial

I will not possess or use illegal drugs, nor will I possess or use alcohol or tobacco in the context of my service. *

Please initial

I will not use or tolerate profanity in the presence of children. *

Please initial

I understand that any violation of this agreement may be grounds for dismissal, discipline, or other action by the church. *

Please initial

Do you have a contagious disease, health issue, or history of emotional illness that would currently place children, other workers, or yourself at risk? *

Have you ever engaged in any conduct that would be regarded as criminal child abuse or neglect? *

Do you have any reason to believe that your background check will disclose any information that would suggest that you should not serve in the Howe Methodist Kids Ministry? *

Authorization and Signature

Please initial the following fields to acknowledge that you agree with each statement.

I recognize that Howe Methodist Church is relying on the accuracy of the information I provide on this application. I attest and affirm that the information I have provided is absolutely true and correct. *

Please initial

I authorize Howe Methodist Church to contact any person or entity listed on application, and I further authorize any such person or entity to provide the organization with information, opinions, and impressions relating to my background or qualifications. *

Please initial

Howe Methodist Church wishes to maintain in confidence all information including data, commercial, and strategies, and know-how disclosed by Howe Methodist Church to me, directly or indirectly, in written, oral, or other tangible forms. *

In this regard, I agree that I will not disclose the confidential information and/or trade secrets with others without prior written consent of Howe Methodist Church both during or after my service.

I voluntarily release Howe Methodist Church and any such person or entity listed on this application from liability involving the communication of information relating to my background or qualifications. *

Please initial

I understand that I am entitled to a complete and accurate disclosure of the nature and scope of any consumer report on me. I also understand that I may receive a written summary of my rights under 15 U.S.C. § 1681 et. seq. *

Please initial

I authorize Howe Methodist Church to conduct a background inquiry that may include criminal records, public records, and personal references. *

Additionally, I agree to all statements above and certify that I have properly initialed each statement and/or accept that any text placed in the fields provided will be considered acceptance of the statements.

By entering my name below, I understand that I am submitting my application for a nursery worker position at Howe Methodist Church. *

Today's Date *

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