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KINGDOM KIDS VOLUNTEER APPLICATION

This form is to be completed by all adult applicants. This form must be completed and evaluated before the applicant can be included in ministry activities. This form is being used to help us provide a safe and secure environment for those who participate in our programs. Please print your answers and please answer all questions.

Your name *

Last name

Email address *

Gender *

Phone number *

Phone type

Marital status *

Have you attended FFC Vision Track? *

Yes

To become part of the kids department team, we require all volunteers to attend FFC Vision Track *

please follow this link to register for the next Vision Track:

https://ffchurch.churchcenter.com/registrations/events/1723165

Favorite coffee/drink, and from where?

DESIRED INVOLVEMENT

What age group do you wish to work with? ( you may select several choices) *

Nursery (6 - 23 months)

Kindergarten ( 4 - 5 year olds)

Elementary ( 1st - 3rd grade)

Preteens (4th -5th grades)

Welcome / Check- In Team

The following are my responses to questions about my criminal record history (if any) with descriptions to any questions with a YES answer:

1. Have you ever been convicted or plead guilty before a court of any federal, state, or municipal criminal offense? *

(excluding minor traffic violations)

Yes

2. Have you ever received deferred adjudication or similar disposition for any federal, state or municipal criminal offence? *

Yes

3. Have you ever received probation or community supervision for any federal, state or municipal criminal offence? *

Yes

If yes, please explain *

4. Have you ever been convicted of any criminal offense in a country outside the jurisdiction of the United States? *

Yes

If yes, please explain *

5. As of the date of this authorization, do you have any pending criminal charges of any type against you? *

Yes

6. Are you currently using or have you during the last 6 months used illegal drugs or other illegal controlled substances? *

Yes

If yes, please explain *

7. Have you been intoxicated in the last 6 (six) months? *

Yes

8. Have you viewed, or participated in the creation, dissemination of, or used, pornogrophy or pornographic materials of any type? *

Yes

ADULT TO MINOR SAFE TOUCH AND INTERACTION POLICIES AND PROCEDURES

In order to prevent physical and sexual abuse, as best possible, and to protect all adults from false accusations, we have created the following safety touch policies and procedures. All adults who will be directly involved with the caretaking and instruction of all minors under the protection of our church, whether as an employee or volunteer, must read through and agree to abide by all of these policies. These policies will be closely monitored. Any infractions will result in removal from ministry. Please ask any questions you may have before signing the statement declaring you have read and agree to conform to this policy. Please understand we are not trying to be offensive, but must be very specific about behaviors that are acceptable and those behaviors that are not acceptable. (please initial after reading each statement.)

1. Always remain visible to others when interacting with children or students. There must be a minimum of two non-related adults in the classroom for all children through second grade. *

2. We encourage you to use safe touch methods as often as possible: a pat on the back, handshake, tussle their hair, shoulder hugs. *

3. All physical contact should occur in reference to the needs of the minor -- not the needs of the worker. *

4. All physical contact should encourage self-esteem. *

5. All physical contact should take place in public. It should never occur behind closed doors, in private or secret. *

6. All physical contact should be age-appropriate. Holding a toddler on your lap is appropriate, while having a fourteen year old sit on your lap is inappropriate. *

7. Discipline must never include physical contact, unless you are restraining a child if he/she has become violent. Workers should not administer any physical discipline (i.e. spanking) to their own child in the presence of other children. *

8. Adults must not discuss (with minors or in the presence of minors) details concerning sexual activity. *

9. Adults must, in a considerate manner, redirect minors from inappropriate touching, sexual discussions, or sexual language. In case of resistance, please contact the ministry leader or the minor’s parents. *

10. Volunteers must dress modestly. A volunteer who dresses in a way which exposes genitals, breasts or underwear will be asked to leave the classroom/activity. *

11. Adults must avoid full body frontal hugs with minors. *

12. When assisting a young child in the restroom, the door is to remain ajar. *

13. The only assistance a worker is to provide to a child in the restroom is assistance with buttons, zippers, etc. The worker should not assist the child in any other way, i.e. wiping, changing diapers or pull-ups, etc. *

14. Massages given to or received from minors are unacceptable. *

15. Children shall not be shaken or hit, and they shall not receive threats of being shaken or hit. *

16. Children shall not be humiliated, yelled at, or rejected. *

17. Children shall not be subjected to abusive or profane language. *

18. Children shall not be subjected to any form of corporal punishment or threats of corporal punishment. *

19. No adult worker shall give a ride to any minor unless there are others in the car with them AND the parents of said minors have agreed to that ride. *

I have read and agree to conform to the Adult to Minor Safe Touch and Interaction Policies and Procedures. *

Please type in your name below as an electronic signature

DISCLOSURE AND AUTHORIZATION FOR EMPLOYER TO ACCESS CONSUMER REPORTS

Flame of Fire Church, 9719 Lincoln Village Dr, Sacramento, CA 95827 (916) 472-0847

AUTHORIZATION
I hereby authorize, without reservation, the obtaining of “consumer reports” or “investigative consumer” reports by Flame of Fire Church at any time after receipt of this authorization and throughout my employment or volunteer service, if applicable. I further authorize and request, without reservation, any present or former employer, school, police department, state or federal agency, financial institution, division of motor vehicles, consumer reporting agencies, or other persons or agencies having knowledge about me to furnish Protect My Ministry or Flame of Fire Church with any and all background information in their possession regarding me, so that my employment qualifications may be evaluated and/or reassessed. I also agree that a fax or photocopy of this authorization with my signature should have the same authority as the original.
By signing below, I certify: (1) that I have read and fully understand this disclosure and authorization; (2) that all of the information I am providing is true, complete, correct and accurate; and (3) that I have received the attached Summary of Your Rights under the Fair Credit Reporting Act (15 U.S.C. §1681 et seq.).
The following is information required in order for Flame of Fire Church to obtain a complete consumer report:

FULL LEGAL NAME (First, Middle and Last name): *

OTHER OR FORMER NAMES (AKA, Maiden Names, Married Names, Surnames, Etc.) *

SOCIAL SECURITY NUMBER: *

Birthdate *

Address *

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

By typing in your name indicates your signature, I certify: *

(1) that I have read and fully understand this disclosure and authorization;
(2) that all of the information I am providing is true, complete, correct and accurate;
and (3) that I have received the attached Summary of Your Rights under the Fair Credit Reporting Act (15 U.S.C. §1681 et seq.).

DISCLOSURE

In connection with your application for employment or volunteer service with: Flame of Fire Church (including any independent contract for services) or when deciding whether to modify or continue your ongoing employment or (if hired) or service, Flame of Fire Church may obtain a “consumer report” and/or an “investigative consumer report” on you from Protect My Ministry, a consumer reporting agency, or from any third party, in strict compliance with both state and federal law. A consumer report is a communication of information by a consumer reporting agency bearing on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living which is used or expected to be used for purposes of serving as a factor in establishing your current and/or continuing eligibility for employment purposes. An investigative consumer report is a report obtained through personal interviews with individuals who may have knowledge of your character, general reputation, personal characteristics, or mode of living. The consumer reports or investigative consumer reports may contain information regarding your credit history (if applicable to position), criminal records, driving history records, education records, previous employment history, social security traces, military records, professional licensure records, drug testing, government records, and other types of background information. You further understand that these reports may contain information concerning the reasons for termination of past employment. You are hereby notified that you have the right to make a timely request for the nature and scope of any investigative consumer report. You are further notified that, prior to being denied employment based in whole or in part on information obtained in the consumer report, you will be provided a copy of the report, the name, address and telephone number of the consumer reporting agency and a description in writing of your rights under the Fair Credit Reporting Act. Inquiries to Protect My Ministry should be directed to Protect My Ministry; Compliance Department; 14499 N. Dale Mabry Hwy, Suite 201 South Tampa, FL 33618

CALIFORNIA APPLICANTS OR EMPLOYEES ONLY:

By signing below, you also acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION PURSUANT TO CALIFORNIA LAW. If you would like to receive a copy of an investigative report at no charge if one is obtained from Flame of Fire Church whenever you have a right to receive such a copy under California law, please submit a written request for such a copy to Flame of Fire Church Offices.

NOTICE REGARDING BACKGROUND INVESTIGATION PURSUANT TO CALIFORNIA LAW

Flame of Fire Church intends to obtain information about you for employment purposes from an investigative consumer reporting agency or consumer credit reporting agency. Thus, you can expect to be the subject of “investigative consumer reports” and “consumer credit reports” obtained for employment purposes. Such reports may include information about your character, general reputation, personal characteristics and mode of living. With respect to any investigative consumer report from an investigative consumer reporting agency (“ICRA”), the Company may investigate the information contained in your employment application and other background information about you, including but not limited to obtaining a criminal record report, verifying references, work history, your social security number, your educational achievements, licensure, and certifications, your driving record, and other information about you, and interviewing people who are knowledgeable about you. The results of this report may be used as a factor in making employment decisions. The source of any investigative consumer report (as that term is defined under California law) will be Protect My Ministry; Compliance Department; 14499 N. Dale Mabry Hwy, Suite 201 South Tampa, FL 33618

The source of any credit report will be Protect My Ministry; Compliance Department; 14499 N. Dale Mabry Hwy, Suite 201 South Tampa, FL 33618.

The Company agrees to provide you with a copy of an investigative consumer report when required to do so under California law. Under California Civil Code section 1786.22, you are entitled to find out from an ICRA what is in the ICRA’s file on you with proper identification, as follows: In person, by visual inspection of your file during normal business hours and on reasonable notice. You also may request a copy of the information in person. The ICRA may not charge you more than the actual copying costs for providing you with a copy of your file. A summary of all information contained in the ICRA’s file on you that is required to be provided by the California Civil Code will be provided to you via telephone, if you have made a written request, with proper identification, for telephone disclosure, and the toll charge, if any, for the telephone call is prepaid by or charged directly to you.
By requesting a copy be sent to a specified addressee by certified mail. ICRAs complying with requests for certified mailings shall not be liable for disclosures to third parties caused by mishandling of mail after such mailings leave the ICRAs.

“Proper Identification”

includes documents such as a valid driver’s license, social security account number, military identification card, and credit cards. Only if you cannot identify yourself with such information may the ICRA require additional information concerning your employment and personal or family history in order to verify your identity.

The ICRA

will provide trained personnel to explain any information furnished to you and will provide a written explanation of any coded information contained in files maintained on you. This written explanation will be provided whenever a file is provided to you for visual inspection.
You may be accompanied by one other person of your choosing, who must furnish reasonable identification. An ICRA may require you to furnish a written statement granting permission to the ICRA to discuss your file in such person’s presence.

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Flame of Fire
info@ffministry.com
916-472-0847