Application to Serve with LBC Children & Students

Full Legal Name

Address

This address will receive a confirmation email

Phone

Drivers License #

Are you a covenant member of Liberty Baptist Church?

Yes No

How long have you been attending Liberty Baptist Church?

Sex

Male Female

Date of Birth

Marital Status

Single Married Separated Divorced Widowed

How long have you lived at your current address?

Previous Address

List all other cities and states where you have lived as an adult:

Child Protection Policy Adherence

Everyone who serves with children or students during Liberty Baptist Church functions must agree to abide by Liberty Baptist Church's Child Protection Policy and Code of Conduct.

Please read both of the documents linked below in their entirety before continuing with the application, to ensure that you are able to comply with our stated policy and procedures.

LBC Child Protection Policy Manual

LBC Volunteer Code of Conduct

I affirm that I have read the LBC Child Protection Policy Manual in its entirety.

Yes No

I affirm that I have read the LBC Volunteer Code of Conduct in its entirety.

Yes No

I affirm that I can, in good conscience, comply with the entirety of the LBC Child Protection Policy and Volunteer Code of Conduct.

Yes Yes, with reservations No

Previous Experience Working with Children

Please list all previous volunteer work or employment involving children or students (list each organization's name, type of work, and the dates served).

List any talents, vocations, preparation, training, or other experiences that have equipped you to work with children or students.

Personal History and Experience

Because we care for children and desire to protect them, please answer the following questions. We understand that the answers to these questions may be private and deeply personal, and we will protect your privacy in every possible context. It is the position of Liberty Baptist Church that suspicions or allegations of child abuse or neglect will be reported to relevant state authorities.

Why do you want to work with children or students at Liberty Baptist Church?

Do you have a preference concerning the age group or sex of children or students with whom you would like to work? If so, what is the basis for this preference?

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

When you are unhappy, angry, or emotional about a person or circumstance, what do you do?

Have you experienced any significant physical or emotional stressors within the past year, such as the loss of a parent, spouse, or child, extreme ill health, or any emotional or physical crisis? If so, please briefly explain.

Have you ever physically or sexually abused a child?

Has someone ever accused you of physically or sexually abusing a child, or molesting a child?

References

Each applicant must submit the names, emails, and phone numbers of at least one professional reference, one personal reference, and one family member (these references cannot be your spouse). Additional references may be submitted if deemed helpful by the applicant in allowing Liberty Baptist Church to determine the applicant's fitness for serving with children and students.

The professional reference should be familiar with the quality of the individual's work or involvement with children. One of these references should be a person of the opposite sex. Please contact these references and inform them an authorized Liberty Baptist Church Child Protection Team member will be contacting them.

Personal Reference First and Last Name

Personal Reference Email

Personal Reference Phone

Professional Reference First and Last Name

Professional Reference Email

Professional Reference Phone

Family Reference First and Last Name

Family Reference Email

Family Reference Phone

Is one of the references above a person of the opposite sex?

Yes No

Application to Serve with LBC Children & Students

Description

Please Fix the Following