To apply for this position, please complete the following steps below:

  1. Staff Leader Application

  2. Voluntary Disclosure Agreement

  3. Send Reference Link to two references

Staff Leader Application

Name *
Name
Home Address *
Home Address
Birth Date *
Birth Date
Sex *
Cell Phone Number *
Cell Phone Number
Are you physically able to perform the duties of the position for which you are applying? *
Do you have any medical or physical conditions that we need to be aware of? *

Voluntary Disclosure Agreement

Name *
Name
Home Address *
Home Address
Do you have a passport? *
Birth Date *
Birth Date
Sex *
Cell Phone Number *
Cell Phone Number
School/College Address
School/College Address
City, State & Number of Years (include college and home residences))
2. Have you ever been convicted of any crime relating in any manner to children and/or your conduct with them? *
3. Have you ever been convicted of any crime including, but not limited to, those listed below and/or any crime similar in any manner to those listed below: *
• Indecent assault and battery on a child under fourteen • Indecent assault and battery on a mentally retarded person • Indecent assault and battery on a person who has obtained the age of fourteen • Rape • Rape of a child under sixteen with force • Assault with intent to commit rape • Kidnapping of a child under sixteen with intent to commit rape • Distribution and trafficking of narcotics or other controlled substances • Intent to commit any of the above crimes
4. Have you ever been judged liable for civil penalties or damages involving sexual or physical abuse of children? *
5. Are you now or have you ever been subject to any court order involving sexual or physical abuse of a minor, including, but not limited to a domestic order or protection? *
6. Have your parental rights ever been terminated for reasons involving sexual or physical abuse of children? *
I understand that (please check each box below) *
By signing my name below, I certify that I have read the above information. My signature also certifies my understanding of and agreement with the above statements.
Date *
Date

Staff Leader Reference Form

Applicant, please complete the staff leader reference form below, then email this link to your two references:

http://www.hopechurch.me/reference-form

This reference is for *
This reference is for
Applicant please print your name here
Please check all that apply
E-Signature *
E-Signature
Date *
Date