Form Entry

Thank you for your interest in volunteering with the Life Center!

Any questions, please email mail@changingourcity.org. If you need more information before filling out the form, or are just curious about volunteer, please feel free to reach out.

Please fill out this form for your background check.

First Name

Last Name

Mobile Phone

Birthdate

/ /

Gender

Male Female

Show Spouse

Address

Marital Status

What area do you want to serve with? What is the length of the commitment to serving you are looking to make?

Past states you have lived in

Have you ever been convicted of, or plead guilty to, a felony or crime?

No Yes

Where you a victim of either abuse or molestation while a minor? (We are asking if you were a victim of either abuse or molestation while you where a minor. If you prefer, you may discus this answer with the senior pastor rather than answering it on this form. Answering yes will not automatically disqualify an applicant. However, some courts have said that the statistical correlation between persons who abuse children and where themselves abused as minors is so high, that is is a matter of concern. Our primary concerns are the welfare of our children and your own emotional, spiritual, and psychological healing. )

No Yes Prefer not to answer on this form

Upload image of Picture ID - Must be Federal or State ID.

Upload

What church or school are you a member of: (List, name, address, phone)

List all previous volunteering and work involving children and youth. Please include name of organization and supervisors name.

Do you agree to observe all Life Center policies regarding working minors?

No Yes

Please confirm that all the information you have included is accurate!

Submit