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Your Name (First, Middle Initial and Last)
Home Phone Number
Cell Phone Number
Date of Birth
Social Security Number
Your Email Address
Church where you are a member
Have you ever been accused of child abuse?
In case of an emergency, please notify:
Position Applying For:
What days and hours are you available to work?
What date are you available to start work?
Are you willing to work overtime?
Do you have any special skills, training, or experience which may help you qualify for employment?
Do you have any certificates which would help you to qualify for employment?
Have you ever been convicted of a crime, excluding misdemeanors and summary offenses?
Course or Major
Course or Major
Course or Major
Course or Major
1. Smoking or use of tobacco products in the presence of children is prohibited.
2. Using, possessing, or being under the influence of alcohol or illegal drugs will not be tolerated.
3. I will not abuse children including:
A. Physical Abuse - strike, spank, shake, or slap
B. Verbal Abuse - humiliate, degrade, threaten
C. Sexual Abuse - including inappropriate touching and exposure
4. I must treat children of all races, religions, and cultures with respect and consideration.
5. I must use positive techniques of guidance, including positive reinforcement and encouragement
rather than competition, comparison or criticism.
6. I shall abstain from humiliating or frightening discipline techniques.
7. I shall not use profanity.
8. I will refrain from an intimate display of affection toward others.
9. I must be free of physical and psychological conditions that might adversely affect children’s health, including fever or contagious conditions.
10. I will portray a positive role model for children & youth by maintaining an attitude of respect, loyalty, patience, integrity, courtesy, tact and maturity.
11. I will do everything in my power to avoid being put in a situation where I am alone with a child or youth other than my own.
12. Suspected abuse or neglect of a child should be reported to the school office.
13. I understand that as a volunteer or paid worker for Southcrest Christian School, I will be subject to a background check, including criminal history.
I understand that any violation of this code may be grounds for removal as a paid worker.
Please use the following questions as a guide to share your testimony with me. Please us the
back of the page if you need more space.
Date of Salvation
Date of Baptism
Were you baptized after you were saved?
Were you baptized by Immersion?
What my life was like before I received Christ
How I knew that I needed Christ
What took place when I received Christ
How my life has been different since Jesus saved me
No person may serve with youth or children who has ever been convicted of any Disqualifying offense, been on probation or received deferred adjudication for any disqualifying offense, or has any presently pending criminal charges of any disqualifying offense before a determination of guilt is made including any person who is presently on deferred adjudication.
Disqualifying offenses are as follows:
a. A felony or misdemeanor or classified as an offense against the person or family, or involves an offense against the person or family.
Examples: Offenses against the person include, but are not limited to murder, assault, sexual assault, injury to a child, and abandoning or endangering a child.
Offenses against the family include, but are not limited to bigamy, incest, interference with child custody, enticing a child, and harboring a runaway child.
b. A felony or misdemeanor classified as an offense against public order or indecency.
Examples: Offenses against public order or indecency include, but are not limited to prostitution, obscenity, sexual performance by a child, possession or promotion of child pornography, and disorderly conduct.
c. A felony or misdemeanor violation of any law intended to control the possession or distribution of any substance included as a controlled substance in the Texas Controlled Substances Act.
Driving while intoxicated is not a disqualifying offense, but you may not drive a church vehicle.
All other convictions or questions are subject to discussion on a case by case basis. At least two staff persons will interview the candidate and discuss at length the issue and possible levels of service.
I understand that the responsibilities I am assuming involve contact and/or
Interaction with minors, a condition for accepting the responsibilities is that I an not one who
has ever, or currently abuses minors, including, but not limited to abusing them sexually. I
also understand that condition for accepting the responsibilities is that I do not have a
paraphiliac diagnosis (example: pedophilia, exhibitionism, and voyeurism.)
No bare feet
When you wear sandals - clean feet & toe-nails
Hair - neat and clean
Skirts - knee length
Modest necklines (you will be bending over to take care of children)
NO tank tops
Modesty in wearing clothes that are not too tight - tops, skirts, jeans, etc.
No mid-drifts showing
No underwear showing at the waistline
No tongue, nose, belly button, or body Piercing (showing)
No jeans that the hems have walked on making the hem frayed and dirty
Please start with you most recent job and include all periods of employment, self-employment, and volunteer work
Reason for Leaving
Reason for Leaving
May we contact the employers listed above?
List any volunteer work you have done with children
List any talents or special skills in art, music, drama, etc.
Certification and Acknowledgement
I am aware that a criminal history background record check will be made on all employees. I authorize the school to
thoroughly investigate my work experience and other matters related to my suitability for employment. In addition, I hereby
release the school, my former employees, and all other persons from any and all claims, demands, or liabilities arising out of, or in any way related to, such disclosure. I acknowledge that, if employed, both the school and I have the right to terminate the employment relationship at any time, with or without advance notice. This employment-at-will relationship will remain in effect throughout my employment with the school and may not be modified by any oral or implied agreement. In the event of employment, I understand that false or misleading information given in my application or interview may result in termination.
WE BELIEVE the Bible to be the inspired, the only infallible, inerrant Word of God
(2 Timothy 3:15; 2 Peter 1:21).
WE BELIEVE there is only one God, eternally existent in three persons - Father, Son, and Holy Spirit (Genesis 1:1; Matthew 28:19; John 10:30).
WE BELIEVE in the deity of Christ (John 10:33); His virgin birth (Isaiah 7:14; Matthew 1:23; Luke 1:35); His sinless life (Hebrews 4:15; 7:26); His miracles (John 2:11); His vicarious and atoning death (1 Corinthians 14:3; Ephesians 1:7; Hebrews 2:9); His resurrection (John 11; 25; 1 Corinthians 15:4); His ascension to the right hand of the Father (Mark 16:19); His personal return in power and glory (Acts 1:11; Revelation 19:11).
WE BELIEVE in the absolute necessity of regeneration by the Holy Spirit for salvation because of the exceeding sinfulness of human nature and that men are justified on the single ground of faith in the shed blood of Christ and that only by God’s grace and through faith alone we are saved (John 3:16-19; Romans 3:23; Romans 5:8-9; Ephesians 2:8-10; Titus 3:15).
WE BELIEVE in the resurrection of both the saved and lost; they that are saved unto the resurrection of life, and they that are lost unto the resurrection of damnation (John 5:28-29).
WE BELIEVE in the spiritual unity of believers in our Lord Jesus Christ (Romans 8:9;
1 Corinthians 12:12-13; Galatians 3:26-28).
WE BELIEVE in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life (Romans 8:13-14; 1 Corinthians 3:16; 6:19-20; Ephesians 4:39; 5:18).
WE BELIEVE that all true believers endure to the end. Those whom God has accepted in Christ, and
sanctified by His Spirit, never fall away from the state of grace, but shall persevere to the end. Believers may fall into sin through neglect and temptation, whereby they grieve the Spirit, impair their graces and comforts, bring reproach on the cause of Christ, and temporal judgments on themselves, yet they shall be kept by the power of God through faith and salvation. (Genesis 12:1-3; Exodus 19:5-8; 1 Samuel 8:4-7,19- 22; Isaiah 5:1-7; Matthew 16:18-19, 25:34; Luke 1:68-79, 2:29-32, 24:44-48; John 1:12-14.
WE BELIEVE marriage is a covenant between one man and one woman and God immutably bestows gender
upon each person as male or female to reflect His image. (Genesis 2:22-24)
Former Name(s) and Dates
The information contained in this application is correct to the best of my knowledge. I hereby
authorize Southcrest Baptist Church and its designated agents and representatives to conduct a
comprehensive review of my background causing a consumer report and/or an investigative consumer
report being generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit reports, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving record, birth records, and any other public records.
I further authorize any individual, company, firm, corporation, or public agency (including the Social Security Administration and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me, to Southcrest Baptist Church or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. Southcrest Baptist Church and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicant's personal information, including, but not limited to, addresses, social security numbers, and dates.