Application to Serve in MinistryApplication to Serve in Ministry This form is to be completed by prospective volunteers of BSMC to serve in a position of supervision over children, youth, or vulnerable adults during ministry activities to occur within the facilities of the church, on a church bus, or otherwise sponsored by or affiliated with BSMC. Completion and signature on this application form acknowledges that a national criminal history search of the prospective volunteer will be conducted by the church and cost associated with such search will be paid by the church. All applications will be handled in a secure and confidential manner.Primary Ministry Area * Children (Age 0-5th grade) Youth (6th-12th grades) Scouts Congregational Care Recreation Missions & Outreach OtherOtherSelect all that applyFull Legal Name * Full Legal Name First Name First Name Middle Name Middle Name Last Name Last Name Preferred Name Social Security Number: Please call Debbie Friddle at 864-371-6083 to provide this over the phone. Date of Birth * Address (No Post Office Boxes) * Address (No Post Office Boxes) Street Address Street Address Address Line 2 Address Line 2 City City State / Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State / Province ZIP / Postal Code ZIP / Postal Code Email * Home Phone Work Phone Cell Phone Employer * Occupation * Have you been associated with Buncombe Street Methodist Church for at least six months? (previously BSUMC) * Yes No For how long? Have you ever been convicted of, or plead guilty to a crime, whether a misdemeanor or a felony, involving negligence, abuse, violence, sexual misconduct, or immoral character? * Yes No Please explain fully Are you now or have you ever registered as a sex offender in any city, county, state, or country? * Yes No Please explain fully Are you available for periodic Safe Sanctuary training? * Yes NoDo you have prior First Aid or CPR training? * Yes No Previous training type or certifications you hold: If references are required, you will receive an email from Ministry Safe to request that information. Please respond as soon as possible to complete the process. (Recertification applications will not require references) * I acknowledge and understand the above statement I attest to the accuracy of the personal information provided, that I have read & received a copy of the Safe Sanctuary Policy and I also consent and acknowledge that a national criminal records search will be conducted. * I attest to the accuracy of the personal information provided, that I have read & received a copy of the Safe Sanctuary Policy and I also consent and acknowledge that a national criminal records search will be conducted. Submit If you are human, leave this field blank.
