ABOUT US
NEXT STEPS
MINISTRIES
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GIVE
MISSIONS
ABOUT US
NEXT STEPS
MINISTRIES
Watch
GIVE
MISSIONS
Background Check & Consent
First Name
*
Middle Name
*
Last Name
Present Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email Address
*
Phone
*
(###)
###
####
Date of Birth
*
MM
DD
YYYY
Place of Birth (City & State)
*
Driver's License #
*
Social Security #
*
Marital Status
*
Single
Married
Spouse's Name (If Applicable)
IMPORTANT QUESTIONS
Do you drink alcohol?
*
Yes
No
Let's talk about it
Are you currently in recovery from drugs or alcohol addiction?
*
Yes
No
Let's talk about it
If yes, how long have you been sober?
Are you using illegal drugs?
*
Yes
No
Let's talk about it
Have you ever had sexual relations with a minor after you were an adult?
*
Yes
No
Let's talk about it
RELATIONS | If yes, what year?
Have you ever been convicted of any form of child abuse?
*
Yes
No
Let's talk about it
ABUSE | If yes, what year?
Have you ever been accused of any crime?
*
Yes
No
Let's talk about it
Have you ever been convicted of any form of a crime?
*
Yes
No
Let's talk about it
Is there currently any physical abuse, neglect or unhealthy habits in your life or home?
*
Yes
No
Let's talk about it
Are there any moral or ethical issues we need to know about?
*
Yes
No
Let's talk about it
If YES to any of the above, Please Explain
AUTHORIZATION, CONSENT & AGREEMENT
I authorize the Minnesota Bureau of Criminal Apprehension to disclose all criminal history record information to The River Church for the purpose of serving in the position indicated on my advanced application (This is the application you initially filled out before this background check).
*
I have read and understand this section.
The information contained in this application is correct to the best of my knowledge. I authorize any references or churches to give you any information (including opinions) that they may have regarding my character and fitness for children's work. In consideration of the receipt and evaluation of this application by The River Church, I hereby release any individual, Church, youth organization, charity, employer, reference, or any other person/organization, including record custodians, both collectively and individually, from any and all liability for damages of whatever nature which may at any time result in me, my heirs or family, on account of compliance or any attempts to comply, with this authorization. I waive any right that I may inspect any information provided about me by any person or organization identified by me in this application process.
*
I have read and understand this section.
Should my application be accepted, I agree to be bound by the Bylaws and Policies of The River Church and refrain from unscriptural conduct in the performance of my services on behalf of the church. I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release of my own free act. This is a legally binding agreement which I have read and understand. The expiration of this authorization shall be for a period no longer than one year from the date this application is submitted.
*
I have read and understand this section.
Do you give The River Church authorization to process this form? Please indicate Yes or No
*
No
Yes
Thank you!
