I'm New
Who We Are
Directions
What to Expect
About Us
What We Believe
Welcome New Members
Staff
Job Openings
Newsletter
Worship
In-Person Worship
Livestream Worship
Sermon Recordings
Children & Youth
Birth - Grade 6
Grades 7-8
Confirmation
Grades 9-12
Preschool
Resources
Programs
Music
Mom's Midweek Ministry
Adult Education
Vintage Spirits
College Age Ministry
Library at HSLC
Community Pantry
Spirit Connections
Midweek Meal
Committees
Social Justice
Community Statements
Contemplative Garden and Columbarium
Congregational Meetings
Pastor Mike's Crossways
Giving
Calendar
I'm New
Who We Are
Directions
What to Expect
About Us
What We Believe
Welcome New Members
Staff
Job Openings
Newsletter
Worship
In-Person Worship
Livestream Worship
Sermon Recordings
Children & Youth
Birth - Grade 6
Grades 7-8
Confirmation
Grades 9-12
Preschool
Resources
Programs
Music
Mom's Midweek Ministry
Adult Education
Vintage Spirits
College Age Ministry
Library at HSLC
Community Pantry
Spirit Connections
Midweek Meal
Committees
Social Justice
Community Statements
Contemplative Garden and Columbarium
Congregational Meetings
Pastor Mike's Crossways
Giving
Calendar
Safe Haven
Safe Haven
Criminal Background Check Form
Application for Volunteer Form
Renewal for Volunteer Form
Safe Haven Registration
Renewal of Application
Legal First and Middle Name
*
Last Name
*
Other Prior Names
Including maiden names and previously married names
Preferred pronouns
*
He/him, she/her, etc.
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Contact Phone Number
*
(###)
###
####
Date of Birth
MM
DD
YYYY
Email
*
Emergency Contact Section
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Relationship
*
Emergency Contact Phone Number
*
(###)
###
####
Self-Disclosure Section
Have you ever had your driver's license or other license (professional) suspended or revoked?
*
As we go through the volunteer process, we will need a copy of your driver's license or another photo identification. HSLC requires a valid driver’s license or photo id to be on file. If your current driver's license or photo id is expired, you will be contacted to provide another copy
Yes
No
Have you been convicted of, or pleaded guilty or no contest to, any crime?
*
Yes
No
Have you ever been investigated by Child Protective Services or the Department of Social and Health Services for alleged child abuse or neglect?
*
Yes
No
Have you ever been asked not to attend another church or to cease volunteering with any other organization?
*
Yes
No
Is there any fact or circumstance in your background that would call into question the advisability of entrusting you with the supervision, guidance and care of young people?
*
Yes
No
RELEASE AND AUTHORIZATION OF RELEASE OF INFORMATION I have applied for volunteer status at Holy Spirit Lutheran Church (the “Church”). I authorize the Church to contact any person or entity to obtain information concerning me, including, but not limited to, the employers, organizations, supervisors, governmental agencies, and references listed in my application. Without limiting the foregoing, I understand and agree that this release allows the Department of Social and Health Services, including, but not limited to, Child Protective Services, to release information concerning me. I hereby release and agree to hold harmless from liability any person or organization (whether listed in my application or not) who provides information or references about me to the Church or its officers, employees, volunteers, and agents. I also hereby release and agree to hold harmless the Church and its past, present, and future officers, employees, volunteers, and agents with respect to the obtaining of such information about me. I waive any right I might have to inspect the references provided on my behalf. A digital copy of this release shall be as effective as a signed original. I understand and agree that the Church may conduct a criminal background check on me upon an offer of volunteer status and that the Church may continue to conduct future background checks should I continue to volunteer. I have read this release and authorization of release of information and enter it freely and voluntarily. By signing I certify that the information given is true and complete to the best of my knowledge.
*
Please type your name below as signature
Date
*
MM
DD
YYYY
Thank you!
Don’t forget to fill out your
Criminal Background Check Form
(if you are 18 or older).
