Next Step: Volunteer and/or Membership Application (2023) • North Central Church

Thanks for your interest in joining a team and/or becoming a member here at North Central as we seek to see Gospel transformation in every heart, home and neighborhood.

One of the necessary first steps is filling out this application, which is a standard document that all volunteers and members complete.** We realize it's tedious to get through, but we believe it's an important step in ensuring that every environment we create at North Central is safe for everyone, so thank you for taking some of your valuable time to complete.

All information contained in this application will be kept confidential. It will be available only to those who have a genuine need to know in order to carry out their responsibilities at North Central Church or as required by law.

Once you're done, don't forget to click the "Submit" button!

**This application only needs to be filled out one time. For instance, if you fill it out to volunteer, you do not need to fill it out in it's entirety again should you decide to join as member at a later date (simply notify our office of you intent to become a member).

**Please note that 3 references are required below. Family members cannot be used as references.

Personal Info

First Name *

Mailing Address *

Home City *

Home State *

Home Zip Code *

Status

Last Name *

Date of Birth *

Email Address *

Phone Number *

Occupation *

Anniversary

Local Church Membership

How long has North Central been your church home? *

Briefly describe your relationship with Jesus *

Have you been baptized in water since placing your faith in Jesus? *

Yes

Are you open to the biblical experience (1 Cor. 12 $ 14) referred to as the baptism in the Holy Spirit? *

Yes

If no, please elaborate.

Are there any doctrines taught by a teacher or pastor of North Central Church with which you disagree? *

Yes

If yes, please elaborate.

Are you completing this application for: *

Membership

Volunteer Team

Membership and Volunteering

**If you are completing application for membership, please complete the Membership Covenant here.

Which North Central team are you looking to join? If you need to talk with someone about this, please indicate in the space below. *

Other:

What is your previous local church affiliation, if any? *

Local Church Name

Church Address

Church Phone

Pastor's Name

Reason for leaving

Length of church involvement

Describe your other personal strength and experience. *

List your 3 strongest skills: *

Other skills I'm learning and/or working on are: *

Please list any significant experiences that seem to have had a profound impact on your life. How would you describe their impact? *

Please list any significant passions that drive the priorities in your life or stir your heart. *

If you have not completed the Spiritual Gifts Assessment and the Personality Assessment, please do so. Please input your results.

Click here for Spiritual Gifts Assessment

Click here for Personality Assessment

Spiritual Gifts *

Personality Style

CONFIDENTIAL

Background Screening

The following section is used to conduct confidential background checks on all North Central Church volunteers. All information provided is strictly confidential and will only be used to meet the requirements of the screening procress.

REFERENCES

It's required for all applicants to list 3 references who are not family members. These references must have known you for at least a year and have a sincere knowledge of your character & work with children. References are not required to be connected to North Central Church.

Character Reference #1 (application cannot be processed if this is left incomplete)

Name *

Address *

City, State, Zip *

Email *

Nature of Relationship (Family members cannot be used as references.) *

Length of Time Known *

Character Reference #3 (application cannot be processed if this is left incomplete)

Name *

Address *

City, State, Zip *

Email *

Nature of Relationship (Family members cannot be used as references.) *

Length of Time Known *

Character Reference #2 (application cannot be processed if this is left incomplete)

Name *

Address *

City, State, Zip *

Email *

Nature of Relationship (Family members cannot be used as references.) *

Length of Time Known *

PREVIOUS WORK EXPERIENCE WITH MINORS (List all organization work involving minors during the past 5 years.)

Organization(s) Name(s) *

Work Performed *

Supervisor Name(s) *

The following questions are part of a process to help provide a safe and secure environment. All information is confidential. (Answering YES to any of the following questions does not automatically disqualify someone for church service.)

Reducing the Risk Policy

Please click here to read the Reducing the Risk Policy.

Criminal Records Check and Authorization

(All applicants much complete this section; only those 18 and older are subject to check.) I hereby request a criminal background check and the release of any information which pertains to any record of convictions in its files or in any criminal file maintained on me whether local, state, or national. I hereby release any criminal law enforcement agency from any and all liability resulting from such disclosure. Any person or entity relying on this request may rely on a photocopy or facsimile as if it were an original.

By checking, I

Please select one option. *

Decline (I would like to sign this document in person.)

Authorization Date *

Date of Birth *

Legal Name (Last, First, Middle) *

Additional names used: *

City and State of Birth *

Social Security Number *

Applicant Statement

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 working with or around minors. In consideration of this evaluation by North Central, I hereby release any individual, church, youth organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages or 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 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. I confirm that I have read the Reducing the Risk Policy included with this application and understand its content. Should my application be accepted, I agree to be bound by the Bylaws and policies of North Central and to refrain from unscripted 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.

By checking, I

Please select one option. *

Decline (I would like to sign this document in person.)

I would like a copy of the background check emailed to me

Yes

Office Use Only:

Personal Info

Status

Local Church Membership

CONFIDENTIAL

Background Screening

PREVIOUS WORK EXPERIENCE WITH MINORS (List all organization work involving minors during the past 5 years.)

I prefer to discuss the following questions confidentially with one of our Pastors.

Are you presently facing charges for any criminal offense?

Have you ever been accused of or charged with any offense involving children?

We conduct a police background check on all adult applicants. Do you have any objections?

Have you ever been charged with a misdemeanor or felony?

Have you ever been dismissed from a volunteer position for any reason?

Reducing the Risk Policy

Criminal Records Check and Authorization

By checking, I

Applicant Statement

By checking, I