• Team Member Application

    Team Member Application

    Background Check Renewal
  • Format: (000) 000-0000.
  • Date of Birth *
     - -
  • Gender*
  • Marital Status*
  • I am renewing my background check in*

  • West Ridge Kids
  • Student Ministry
  • Special Needs
  • Guest Services

  • Adult Group Leader
  • Care

  • Personal Situations

  • 1. Have you ever been convicted of a criminal offense (felony or misdemeanor, except for minor traffic violations)?*
  • 2. Have you ever been concerned that you may have an addiction to drugs, alcohol, pornography or any other addiction; or has anyone ever suggested that you may have a problem with any of the above?*
  • 3. Have you ever been reported to a social services agency, law enforcement authority, child abuse registry, or similar organization regarding committing any act of neglecting, abusing, molesting or battering any child or adult? Or have you had any kind of a relationship with a minor that has brought sexual gratification to yourself?*
  • 4. Have you ever been the subject of any disciplinary action, transfer, dismissal, resigned from a job, or been named as a defendant in a civil or criminal lawsuit, as a result of an accident or mishap involving children?*
  • 5. Have you ever been disciplined or dismissed from employment or a volunteer position by any employer, including charitable and religious organizations, following an allegation of sexual misconduct, sexual harassment, or other immoral or inappropriate behavior or conduct?*
  • 6. Do you have any investigation, review, or disciplinary action pending by an employer, organization in which you volunteered, licensing authority, or professional association for sexual misconduct, violence, or misconduct involving children?*
  • 7. Have you ever been diagnosed or treated for any mental illness*
  • 8. Has there been any abuse in your family background with drugs or alcohol or that was emotional, physical or sexual in nature?*
  • 10. Is there any circumstance or pattern in your life, which would make it inappropriate for you to serve with minors or would compromise the integrity of West Ridge Church?*

  • Applicant Statement

    The information contained in this application is correct to the best of my knowledge. I authorize any references listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children or youth work. I authorize the release of the information contained in this application, on a confidential, need to know basis, to any Ministry at West Ridge Church in which I seek a position (volunteer or compensated). In consideration of the receipt and evaluation of this application by West Ridge Church, I hereby release any individual, church, youth organization, charity, reference or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of 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 this authorization. To uphold the confidentiality of the references, I waive any right that I may have to inspect any information provided about me by any person or organization, but I may contact West Ridge Church to inquire about information provided about me.Should my application be accepted, I agree to refrain from unscriptural conduct in the performance of my services on behalf of the Church.Also, I hereby request and authorize the release of any information which pertains to any record of convictions contained in law enforcement files or in any criminal file maintained on me whether local, state or national. I hereby release local, state and national law enforcement agencies from any and all liability resulting from such disclosure.I understand that should any of this information change I will be responsible for notifying the church leadership. This type of information may include: criminal convictions or accusations, mental illness, or other information that could pose a safety risk to serving with kids or students. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement, which I have read and understand.
  • I agree to the above statement and understand this is a legally binding agreement*
  • Today's Date
     - -
  • Please Read!

    Please Read!

    Once you click submit you will be taken to Protect My Ministries to complete the final portion of the process which is a background check authorization form. You will be asked for your basic information again. In addition, you will need to give your social security number. PLEASE NOTE: You must fill out this next form so that we can complete the process.
  • Should be Empty: