Wufoo

First, Middle, and Last Name
I am applying for:
Check-in Infant Young Toddlers 2's and 3's Pre-K, K, and 1st Elementary (2nd-5th)
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone ### - ### - ####
Cell Phone ### - ### - ####
Email
Spirtual Journey
Describe how you became a Christian:
Have you been baptized by immersion? If so, when?
Describe how you arrived at Midtown Bridge Church:
How long have you been attending?
List any previous experience you've had working with children (other churches, training, education):
Please list 2 personal references (not former employers or relatives). Please give their name, how you know them, and the best way to reach them.
Have you ever been charged with, indicted for, or pled guility to an offense involving a minor?
Yes No
If yes, please describe all convictions for the past 5 years:
GENERAL RELEASE FORM

To be completed by all applicants 18 and older.

The purpose of this form is to notify you that an investigatative report will be conducted on you in the course of consideration for this request. The information that is asked for is merely being used for the report.

In other words, we are performing a background check.
First, Middle, and Last Name
Maiden Name or Any Aliases used in the past
Ethnicity
Social Security Number
Date of Birth MM / DD / YYYY
Consent

In connection with this request, I hereby authorize all corporations and law enforcement agencies to release information they may have about me to _____________, the agent acting on behalf of The Midtown Bridge Church.
Electronic Signature
By checking this box you are agreeing to the Consent above and authorizing a background check to be performed.
Do Not Fill This Out

Wufoo

Spirtual Journey

GENERAL RELEASE FORM