Daycare Worker Application

Daycare Children Worker / One-on-One Resident Worker Application

Confidential Application Form

Daycare Children Worker or One-On-One Resident Worker

Welcome! Thank you for considering serving with our ministry. The safety of our residents and their children is our top priority. This application is to be completed by all applicants for any position involving the supervision or custody of minors or any one-on-one interactions with residents.

Please note that this is not an employment application, and volunteers are not considered employees and are not financially compensated.

Personal

First Name

Middle Name

Last Name

Address

City

State

Zip

Home Phone

Cell Phone

Are you 18 years of age or older?

Yes

Date of Birth

In what position do you desire to serve in our children's daycare ministry or one-on-one with residents?

Anyone who has been convicted of either child sexual or physical abuse shall not be allowed to serve in any ministry-sponsored activity or program for youth or children.

Have you ever been under investigation by law enforcement or any other agency for a child molestation or abuse incident?

Yes

Have you ever been charged with, indicted for, pled no contest or guilty to a crime or an offense involving a minor?

Yes

Are you now under charges for any criminal offense?

Yes

If yes to any question above, please explain including dates

References

Personal references (must be 18 years old and not former employers or relatives)

Reference 1 — Name

Address

City/State/Zip

Phone

Reference 2 — Name

Address

City/State/Zip

Phone

Reference 3 — Name

Address

City/State/Zip

Phone

Ministry/Work Experience

Please list other ministries you have worked in during the past five years. Include the type of work involving children or one-on-one interactions that you have performed.

Dates

Name of Ministry or Work

Address

Type of Work Performed

Dates

Name of Ministry or Work

Address

Type of Work Performed

Dates

Name of Ministry or Work

Address

Type of Work Performed

Please list any spiritual gifts, training, education, or other factors that have prepared you for working with children or our residents.

Please write why you want to serve in this ministry.

Applicant Statement

Please read and check each statement below.

I hereby represent and warrant that the information contained in this application is correct and complete to the best of my knowledge.

I authorize any references or any other person or organizations, whether or not identified in this application, to give Rescue Missions Ministries, Inc., DBA Durham Rescue Mission any information (including opinions) regarding my character and fitness for working with children or youth, or one-on-one with residents.

I hereby release the Rescue Missions Ministries, Inc., DBA Durham Rescue Mission and all of the directors, officers, employees, agents, and volunteers, and any individual, church, denominational agency or official, reference, or any other person or organization, including record custodians, both collectively and individually, and whether or not identified in this application, from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, relating to the obtain, communication, and use of information about me or relating to this authorization on account of compliance or any attempts to comply with this authorization, excepting only the communication of knowingly false information.

I understand that I may consult with an attorney before signing this document. A facsimile or photocopy of this authorization shall be as valid as the original.

I understand that a criminal records check will be conducted on me, and I consent to such check.

Should my application be accepted, I agree to be bound by the policies and procedures of the Rescue Missions Ministries, Inc., DBA Durham Rescue Mission and to refrain from unscriptural conduct in the performance of my services on behalf of the ministry.

I waive any right I may have to inspect any information provided about me by any person or organization described above.

I further state that I have carefully read the foregoing release and know the contents thereof. I sign this release as my own free act. This is a legally binding release which I have read and understand. I have read and understand the above provisions, and agree to them.

Applicant's Signature (type full legal name)

Date

Confidential Application Form

Daycare Children Worker or One-On-One Resident Worker

Personal

References

Ministry/Work Experience

Applicant Statement

Get in Touch

Who We Are

How We Help

Get Involved

Mission Media

Ways to Give

Prospective Client
Check-In Information

Men & Women

For Mothers with Children

Daycare Worker Application

CONFIDENTIAL APPLICATION FOR DAYCARE OR ONE-ON-ONE RESIDENT WORKER

Confidential Application Form

Daycare Children Worker or One-On-One Resident Worker

Personal

References

Ministry/Work Experience

Applicant Statement

Get in Touch

Who We Are

How We Help

Get Involved

Mission Media

Ways to Give

Prospective ClientCheck-In Information

Men & Women

For Mothers with Children

Prospective Client
Check-In Information