Your Name (first, middle, last) *
First Name
Middle
Last Name
Date of Birth*
Full Address: *
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Home Phone: (type "n/a" if non-applicable)*
Mobile Phone: (type "n/a" if non-applicable)*
Email Address:*
Driver's License #:*
Occupation:*
Employer:*
I am interested in serving in the following areas: (choose as many as applicable) *
What skills or special interests would you bring to the ministry? *
How long have you attended Harvest?*
Are you a recognized member of Harvest Bible Chapel?*
If you answered yes to the previous question, how long have you been a member?
Do you have a personal relationship with Jesus Christ?*
If you answered 'yes' above, please briefly describe how you came to a personal relationship with Jesus, and how that relationship impacts your life.
Have you ever been accused, arrested, or convicted for any sexually related crimes?*
Have you ever been accused, arrested, or convicted for any crimes related to physical abuse?*
Are there any circumstances involving your life-style or your background that would call into question your ability to work with children of teens?*
If you answered 'yes' to any of the three preceding questions, please explain:
What church(es) have you attended in the past 5 years? (Please list church name and city, pastor's name, and years attended for each church entry) *
Please list [3] personal references: (include name, address and phone number- no family relationships, please) *
Applicant's Ministry Commitment:
Having committed to Harvest Kids and the habits essential for spiritual maturity, I commit to: 1) prepare for ministry by maintaining and exemplifying a high quality of spiritual maturity through commitment and love for Jesus Christ. 2) support the ministry by praying for the children that I would work with, fully embracing the vision, values, leaders and goals of Harvest Bible Chapel. 3) co-operate with others and other ministries, by serving as a "team player". 4) attend and participate in ministry training that is made available throughout the year.
Applicant's Statement:
The information contained in this application is complete and correct to the best of my knowledge. I authorize Harvest Bible Chapel to contact any person or entity listed in this application, and I further authorize any such person or entity to provide the organization with information, opinions, and impressions relating to my background or qualifications for children's ministry work. I authorize a criminal record check to be conducted pursuant to the screening steps in place for Harvest Bible Chapel. I waive any right I may have to inspect any information provided about me by any person identified in this application. I voluntarily release Harvest Bible Chapel, it's directors, officers, employees, and volunteers from any and all liability involving the communication of information relating to my background or qualifications. I have carefully read the foregoing release, know the contents thereof and I sign this release of my own free will. This is a legally binding agreement that I have read and understood.
Applicant's signature: (submitted as my authorized digital signature) *
First Name
Middle
Last Name
Date Signed: (mo/day/year)*

If you have further questions about HARVEST KIDS children and families ministry, church membership, or this application process, you may contact Pastor Charles Kirby at (616)786-2233 or ckirby@harvestwestolive.org :: YOU ARE LOVED!