Youth Coach Application

Your name *

Email address *

Phone number

Address

How long have you been attending Crossroads Bible Church?

Are you a member of CBC?

Place of Employment:

Area of preference for serving in Youth Ministry:

Select one or both options.

Middle School (6th-8th)

High School (9th-12th)

College Ministry

List all previous experience you've had working with youth:

(Youth Group, Camps, Young Life, Schools, etc.)

List any gifts, skills, training, or education that have prepared you to serve in youth ministry:

Will you commit to attending quarterly planning meetings?

Yes

Are you willing to spend time in preparation to be a small group leader?

Yes

Do you have any physical handicaps or conditions that we need to be aware of?

Answer Yes/No. If yes, please explain:

List (name, phone) other churches you have attended regularly during the past 10 years.

Have you ever physically or sexually abused a child?

Has anyone ever accused you of physically or sexually abusing a child?

Personal References:

Please include 2 people who know you well and who are not former employers/relatives. Include their name and either a phone number or email address.

The information in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information they may have regarding my character and fitness for children's or youth work. *

I release all such references from liability for any damage that may result from furnishing such evaluations to you, and I waive any right that I may have to inspect references provided on my behalf. *

Digital Signature: *

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