Antioch Kid/Student Leader Application

C O N T A C T I N F O

Name

Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. Reply STOP to cancel. View our terms of service & privacy policy.

Preferred T-Shirt Size (if you are in-between sizes, select the larger size)

Are you married?

What is your profession?

What is the name of the company at which you work?

Are you CPR Certified?

Yes
No
Trained but certification is expired

CPR Certification Expiration Date

First Aid Certified

Yes
No
Trained but certification is expired

First Aid Certification Expiration Date

L E A D E R P R E F E R E N C E S

Please select age(s) your prefer to serve?

Birth to 3 Year Olds
Early Childhood (Sunday AM)
Pre-K and Kindergarten
Early Childhood (Sunday AM)
1st and 2nd Grade
Elementary (Sunday AM)
3rd and 4th Grade
Elementary (Sunday AM)
5th, 6th, and 7th Grade
Youth (Sunday AM/Wednesday PM)
8th to 12th Grade
Youth (Wednesday PM)

Would you be interested in serving more than one Sunday a month?

If yes to the previous question, how many Sundays would you like to serve?

2 Sundays (every other week)
3 Sundays
4 Sundays (every week)

Would be interested in other childcare opportunities for leaders/members of our church?

No
I'm not interested in babysitting gigs other than serving at Antioch services/events.
Yes
I'd love to be considered for babysitting jobs and other opportunities for Antioch, and community members.

J U S T F O R F U N

Favorite salty snack(s)

Favorite sweet treat(s)

Your Sonic drink order:

Your coffee/tea drink order:

P E R S O N A L I N F O R M A T I O N

Please describe your previous experience working with kids and youth. (in what setting and for how long)

How long have you attended Antioch?

Do you regularly attend Lifegroup?

P E R S O N A L R E F E R E N C E:

Name of personal reference (must be 18+ and not related to you)

Personal Reference Phone

Personal Reference Email

Relationship to you

How long have they known you?

R E L E A S E A N D V E R I F I C A T I O N

Lifestyle Expectations

I understand that Antioch Norman teaches kids and students to live according to scripture, follow the Word of God, and be obedient to the Holy Spirit. I understand that although I am not expected to be perfect, my lifestyle is expected to be an example to these children and should reflect a consistent, growing, personal relationship with Jesus. I also agree to immediately let the Antioch Staff know if there is anything in my life that may be a hinderance to the well-being of children, students, other volunteers, the staff , or the ministry.

I have read and agree to the terms above.

The information requested below is not intended to embarrass or expose you, and it may not necessarily preclude you from volunteering in this ministry. However, the information requested is necessary to help the church provide a safe and secure environment for all involved.

Due to the sensitivity of some of the information requested, completed applications are submitted securely and kept in a safe location. The information will only be shared with other Antioch Norman staff on a need to know basis.

If you answer YES to any of the following questions, a member of the Antioch staff would like to meet with you to gain a greater understanding of the circumstances related to your answer.

Have you ever been accused of, arrested for, or convicted of any criminal offenses affiliated with violence, abuse, sex, and/or drugs?

Have you ever accused of, arrested for, or convicted of any criminal offense, excluding minor traffic violations?

Have you ever committed physical, emotional, or sexual abuse against another person?

B A C K G R O U N D C H E C K A U T H O R I Z A T I O N

Date of Birth

Place of Birth

Have you ever been known by a different/maiden name?

SS Number

Release of Liability

The information I have provided in this application may be verified by contacting persons or organizations named in this application or by contacting any other person/organization that may have information concerning me. I hereby release and agree to hold harmless from liability any person or organization that provides information of me pursuant to a request related to my desire to serve at Antioch Norman. I also agree to release and hold harmless from liability Antioch Community Church of Norman and its employees and agents fro any information provided or obtained pursuant to a request related to my desire to serve at Antioch Norman.

I, the undersigned, agree to the terms above.