Main Street Baptist Church | Farmington, AR

Youth Mentor (Volunteer) Form

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Marital Status

Do you have any children? If yes, how many?

Briefly State how you came to know Jesus Christ personally

Have you been baptized as an adult?

Yes

No

I'am willing to be baptized

What attracted you to come to our church?

Are you a member of Main Street Baptist Church?

Yes

No

I would like to be

Why do you want to serve at our church?

Are you currently serving in an area in ministry at our church?

Yes

No

Where are you currently serving?

What previous leadership experinces have you had?

In what aspect would you be willing to serve in the student ministry?

Are there any broken relationships in your life?

Yes

No

If yes, please explain:

References

Anyone willing to speak on your behalf that is not familiy (Name, Title/position, contact information)

Another member of Main Street Baptist Church who knows you well and can attest to your suitability to work with students (Name and contact information)

Confidential Information

The following questions are designed to help us promote safe, secure, and loving environment for the students who participate in our programs. This information will be congidential viewd only by select PASTORAL STAFF

If younwould like to disucss any of these matters further with PASTORAL STAFF, please simply indicate that below or leave the form blank.

Have you ever been arrested or charged with a felony?

Have you ever been accused of, participatd in, pled guilty to, or been convicted of child abuse, child neglect, or any other crime against a minor?

Yes

No

I would like to discuss this.

Do you have any ongoing sin struggles that you think would keep you from ministry to students?

Yes

No

i would like to discuss this.

Personal Commitment

In dependence on the Holy Spirit and by God's grace,

I will be faithful and dependable in this ministry

I will see to learn morea bout ministering to Youth as information and training are avaliable

I will faithfully pray for students who are under my care

I commit myself to continuing personal spiritual growth

I commit to knowing when I am scheduled to serve and arriving to serve on time

The information contained in this application is true and correct to the best of my knowledge. I authorize Main Street Baptist Church to contact any references or organization listed in this application. Furthermore, I authorize such references and organizations to provide Main Street Baptist Church with any information they may have regarding my character and fitness for working with students.

Yes

I release Main Street Baptist Church, its agent, and all such references and organizations from any and all liability for damage that may result from furnishing such evaluations to you, and I waive any right that i may have to inspect references provided on my behalf.

Yes

I further state that I have carefully read the foregoing release and know and understand the contents thereof. I sign this release as my own free act. This is a legally binding agreement that I have read and understand.

Yes

Signature

Date of entry