Application of Employment—Supplemental Information—for Working with Minors

Confidential - Bellevue Baptist Church

This application is to be completed by all applicants for employment. It is being used to help the church provide a safe and secure environment for those children and youth who participate in our programs and use our facilities.

Personal

Name

First Name

Last Name

Date

Are you applying for a position that involves interaction with minors as a part of the job's day-to-day responsibilities?*

Yes No

What type of children's work do you prefer?*

Have you ever been convicted of child abuse or a crime involving actual or attempted sexual molestation of a minor?*

Yes No

Please provide a detailed explanation. Failure to provide this information will eliminate the applicant from consideration.*

Were you a victim of abuse or molestation while a minor?*

Yes No

If “yes”, we would like for you to discuss this confidential information with a minister so that we might provide appropriate ministry for you. Please forward your application to the Minister of Biblical Counseling, c/o Bellevue Baptist Church, 2000 Appling Road, Cordova, TN 38016. You will be contacted to schedule an appointment. Answering “yes” or leaving the question unanswered will not automatically disqualify an applicant for preschool or children’s work. This information will be maintained in strict confidence.

Church Activity

List any churches (name and address) you have attended regularly during the past five years.

List all previous church or secular work involving children or youth during the past five years (identify church or organization and type of work).

List any gifts, callings, training, education, or other factors that have prepared you for work with children or youth.