NORTH

 COAST  YOUTH  MINISTRY  APPLICATION  FORM  

 
Thank  you  for  taking  time  to  fill  out  this  application  and  letting  us  get  to  know  you!  Your  answers    
will  be  confidential  and  only  shared  with  appropriate  pastoral  staff  if  deemed  necessary.  
 
GENERAL  INFORMATION  
 
Name_________________________________________________________   Date____________________  
Address___________________________________________________________________________________
City_________________________________    Zip_______________    Birthday__________________________  
Home  Ph#____________________  Work  Ph#____________________  Cell/Pager#____________________  
Occupation___________________________________    Employer___________________________________  
Working  Status  (circle  one)     Full  Time     Part  Time     Student  
Marital  Status  (circle  one)     Married     Single       Divorced  
 
Spouses  first  name______________________________________  Anniversary__________________________  
Names  and  ages  of  children  (if  any)___________________________________________________________  
 
High  School  You  Attended_____________________________________________    Year  Graduated________  
College  Attended_____________________________________________________    Year  Graduated________  
Degrees  you  hold___________________________________________________________________________  
 
If  you  have  any  physical  handicaps  or  conditions  preventing  you  from  certain  activities  list  them  here:  
________________________________________________________________________________________  
________________________________________________________________________________________  
________________________________________________________________________________________  
Are  there  any  special  issues  or  concerns  in  your  life  now  that  would  have  an  impact  on  your  commitment  or  
involvement  in  the  youth  ministry  (habits,  relationships,  other  commitments,  etc)?  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
 SPIRITUAL  LIFE  
 
Please  write  a  brief  testimony  about  how  you  became  a  Christian:___________________________________  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
Please  write  about  any  significant  events  in  your  life  that  have  impacted  you  spiritually:  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
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Describe  three  major  ways  that  you  have  grown  in  your  spiritual  walk  since  becoming  a  Christian:  
1-­‐  _______________________________________________________________________________________  
2-­‐  _______________________________________________________________________________________  
3-­‐  _______________________________________________________________________________________  
How  would  you  describe  you  spiritual  walk  now  on  a  scale  of  1  (poor)  to  10  (great).    Why?  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
Who  do  you  have  in  your  life  that  helps  hold  you  accountable  and  encourages  you  in  your  spiritual  walk?  
__________________________________________________________________________________________
________________________________________________________________________________________  
Why  do  you  want  to  work  with  high  school  students?  
_________________________________________________________________________________________  
__________________________________________________________________________________________
________________________________________________________________________________________  
_________________________________________________________________________________________  
What  are  your  strengths?    (Ie,  what  spiritual  gifts,  talents  or  abilities  do  you  feel  you  have  to  offer?)  
_________________________________________________________________________________________  
__________________________________________________________________________________________  
What  are  your  weaknesses?  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
 LEGAL  AND  LIFESTYLE  INFORMATION  
 
How  do  you  handle  conflict  and  confrontation  with  others?_______________________________________  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
What  are  your  views  on  alcohol,  drugs  and  pre-­‐marital  sexual  activity?______________________________  
_________________________________________________________________________________________  
_________________________________________________________________________________________  
Have  you  ever  been  through  treatment  for  alcohol  or  drug  abuse?  If  yes,  please  explain_________________  
_________________________________________________________________________________________  
Have  you  ever  been  arrested  and/or  convicted  for  a  crime?    If  yes,  please  explain:______________________  
_________________________________________________________________________________________  
Have  you  ever  been  accused  of  or  convicted  of  any  form  of    child  abuse  or  sexual  activity  with  a  minor?  
If  yes,  please  explain:________________________________________________________________________  
Have  you  or  are  you  using  illegal  drugs?  _______________________________________________________  
Have  you  ever  been  a  victim  of  any  form  of  child  abuse?__________________________________________  
If  yes,  have  you  discussed  the  matter  with  a  pastor  our  counselor?__________________________________  
Are  you  willing  to  be  fingerprinted  for  a  criminal  conviction  check  (standard  policy  for  any  organization  
working  with  children)?_____________________________________________________________________  
 
CHURCH  AND  MINISTRY  EXPERIENCE    
 
How  long  have  you  been  attending  North  Coast?_____________________________________________  
Have  you  been  baptized?________________________________________________________________  
Please  list  all  the  churches  you  have  been  a  member  of  or  attended  regularly  in  the  last  five  years:  
__________________________________________________________________________________________  
Have  you  been  or  are  you  presently  involved  in  any  other  ministries  here?  If  yes,  please  list  and  explain  what  
you  did  and  why  you  left  that  ministry:__________________________________________________________  
__________________________________________________________________________________________  
Have  you  been  involved  in  any  ministries  in  other  churches?    If  yes,  please  list  and  explain  what  you  did  and  
why  you  left  that  ministry:____________________________________________________________________  
__________________________________________________________________________________________  
Any  comments  or  questions?_________________________________________________________________  
 REFERENCES  
 
Please  list  three  references  that  we  can  contact  in  regards  to  your  staff  application  to  the  youth  ministry:  
 
1  -­‐  Name__________________________________________________________________________________  
Address___________________________________________________________________________________  
City________________________________    State_______    Zip______________    Phone__________________  
Relationship  to  you_________________________________________________________________________  
 
 
2  -­‐  Name_________________________________________________________________________________  
Address___________________________________________________________________________________  
City________________________________    State_______    Zip______________    Phone__________________  
Relationship  to  you_________________________________________________________________________  
 
 
3  -­‐  Name_________________________________________________________________________________  
Address___________________________________________________________________________________  
City________________________________    State_______    Zip______________    Phone__________________  
Relationship  to  you_________________________________________________________________________  
 
 
All  the  information  I  have  filled  out  in  this  application  is  correct  to  the  best  of  my  knowledge.    I  the  undersigned,  give  my  
  authorization  to  North  Coast  Church  and  its  representatives  to  release  any  and  all  records  or  information  relations  to  working  
with  minors.    The  church  also  has  my  permission  to  contact  any  references  and  appropriate  government  agencies  deemed  
necessary  in  order  to  verify  my  suitability  as  a  volunteer  youth  worker.    I  understand  that  the  personal  information  in  this  
application  will  be  held  confidential  by  the  professional  church  staff.  
Signature__________________________________________________________    Date________________