Safety Team Application Volunteer - Safety Team Application Date First Name * Last Name * Birth Date * Home Phone * Cell Phone * Email * Address * Are you a member of CedarCreek Church * Yes No How long have you been attending * Which Campus do you attend * FindlayOregonPerrysburgSouth ToledoWest ToledoWhitehouse Which Team role(s) do you want to become involved? * Medical Security Have you completed any formal training or Certifications related to this role? * Yes No If Yes, please describe: * What skills would you bring to the team? * What is your occupation? * What other safety- or security-related work experience do you have? (Please List) Organization * Program * Date * Contact * plus1 Add minus1 Remove Have you ever? Been accused, arrested, or convicted of any crime? * Yes No If Yes, Please explain in detail * Been investigated by a state agency for misconduct? * Yes No If Yes, Please explain in detail * Lost or been denied the privilege to carry a concealed weapon? * Yes No If Yes, Please explain in detail * Had any life experience that may hinder you from being a productive safety and security team member? * Yes No If Yes, Please explain in detail * Have been diagnosed with a mental health disorder? * Yes No If Yes, Please explain in detail * Are you aware of any reason why you should not serve on this team? * Yes No If Yes, Please explain in detail * CCW (Please attach photo copies) Do you have a CCW? Yes No If yes, Please attach photo copy Drop a file here or click to upload Choose File Maximum file size: 33.55MB Church Activity - What Church or Churches have you attended in the past five years? Church Name and City/State * Pastor's Name * Years Attended * plus1 Add minus1 Remove References (Other than relatives). Please provide at least two Name/Relationship * Address * Phone plus1 Add minus1 Remove Verification and Release I Recognize that CedarCreek church is relying on the accuracy of the information I provide on this application form. Accordingly, I attest and affirm that the information I have provided is absolutely true and correct. I authorize the organization to contact any person or entity listed on the application form, and I further authorize any such person or entity to provide the organization with information, opinions, and impressions relating tomy background or qualifications. I voluntarily release the organization and any such person or entity listed on the application for fro liability involving the communication of information relating to my background and qualifications. I further authorize the organization to conduct a criminal background investigation if such a check is deemed necessary. I agree to abide by all policies and procedures of the organization and to protect the health and safety of the people assigned to my care or supervision at all times. Please read this document carefully before you sign it Signature signature keyboard Clear If you are human, leave this field blank. Submit This page is maintained by Bryan Bockert / Last Updated: Sunday, December 15, 2024