First Name

Last Name

Email

Phone Number

Birthdate

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Gender

Are you currently serving on another ministry?

Yes

No

THow long ;;have you attendedf Blue Springs Assembly?ext Input

Have you worked withg Children or Youth in or outside of the church?

Yes

No

Please share a little about that.

Are you capable of changing a diaper?

Yes

No

Are you capable of maintaining control over an environment with children?

Yes

No

Are you currently on probation or parole?

Yes

No

Have you ever been subject to allegations, formal accusations, legal charges, verdicts of guilt in relation to criminal offenses, whether classified as misdemeanors or felonies (including, but not limited to, drug-related offenses, acts of violence, crimes against minors under 18, theft, and/or motor vehicle violations)?

Yes

No

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