FPNO Volunteer Application

Thank you for your interest in volunteering with Foster Parents Night Out. Please complete this application if you are interested in serving in any capacity with FPNO, security, kitchen, admin, or walking along side kids.

Filling in the form below acts as a signature and I hereby request that Imago Dei Community do a criminal history check on me which will release any information which pertains to any record of convictions in its files or any criminal file maintained on me whether local, state, or national. I hereby release Imago Dei Community from any liability resulting from such a disclosure. I understand that I may obtain a copy of the report & will be given the opportunity to challenge the accuracy & completeness of this report & obtain a prompt determination as to the validity of the challenge before a final decision is made by the Imago Dei Community. I further understand that I may not be allowed to serve with Foster Parent's Night Out at Imago Dei Community until this background check is completed.

Our FPNO Coordinator will reach out to you with next steps.

Your name *

Email address *

Phone number *

Address *

Birthdate *

Tell us a little about yourself

Help us get to know you better

Is this an area that you commit to serve in for at least the next 6 months? *

Do you consider Imago Dei your home church? *

List any experience/training you have working with children, along with the ages of the children.

What do you do for a living?

Gifts that you would contribute during a future Foster Parent's Night Out (music, art, sports, etc.)

I prefer to work with children in this age range:

I am interested in serving in the following areas:

Is there anything else you'd like for us to know about you?

Background

We ask these next questions in order to establish an openness and awareness of any difficulties in your past. We value open disclosure, security and well-being as we serve the children in our care. While the answers to these questions may not preclude you from working at FPNO, our intent is to foster a culture of transparency.

Please answer carefully, if we discover later on that you've miss-answered or have been evasive in your answers, we will ask you to step out of working with Imago FPNO indefinitely.

Have you ever been convicted of a crime other than a traffic violation? *

Have you ever participated in; been convicted of; pled guilty to; or pled "no contest" to any type of sexual misconduct? *

Have you ever participated in; been convicted of; pled guilty to; or pled "no contest" to any type of abuse? *

Have you ever been convicted of a crime involving the welfare, health, safety or victimization of a minor? *

Are there any addictions (sexual, drug, alcohol, abuse, etc) that you are currently struggling with? *

References

Please list two references who have known you for at least three years (not family members) who can testify to your character and have seen you interact with children.

Reference Name (first and last)

Reference Phone Number

Reference Email

Relationship

Reference #2 Name (first and last)

Reference #2 Phone Number

Reference #2 Email

Reference #2 Relationship