MOSAIC Volunteer Application Form

This application form is for Adult volunteers 18 + years old. We are excited that you have shown interest in volunteering to serve the intercultural population of CLCC. The personal, specific content of this application form provides the precautions necessary to assure everyone of the safest environment possible. Rest assured that we will respect your privacy and the confidentiality of your information. If you have any questions about this form, be sure to contact our Mosaic Ministries Coordinator.

Kyla Takenaka (Mosaic Ministries Coordinator): kyla@clcc.ca

Your name *

Email address *

Contact & Personal Information

Address

Birthdate

Gender

Phone number

Occupation: *

Marital status

Household members

Which campus do you attend *

Have you taken our CLCC Plan for Protection seminar? *

Please select which option best fits you: *

Tell us about yourself...

What are some of your skills/gifts/hobbies that could benefit CLCC: *

Are there any concerns or circumstances that could impact your commitment or affect your ability to serve in any of our ministries? *

Is there anything in your past that you think we need to know about that could affect your ministry with CLCC? *

Tell us about your spiritual life...

Have you been baptized in water by immersion? *

How long have you been attending CLCC? *

Are you a partner at CLCC? *

Do you have a spiritual accountability partner? *

Tell us about your spiritual history...

Briefly describe how you became a Christian: *

How would you describe the current health of your spiritual life? *

Describe your devotional and prayer life: *

Tell us about your lifestyle...

In caring for the people we serve, we believe that it is our responsibility to seek a leader that is able to provide healthy, safe, and nurturing relationships. Please answer the following questions honestly:

Do you vape, smoke cigarettes, marijuana, cigars, pipes, etc. *

Are you using illegal drugs? *

Have you ever gone through treatment for alcohol or drug abuse? *

Have you ever been arrested, detained, or questioned by police for any illegal actions of any type? *

Have you ever had sexual relations with a minor after you became an adult? *

If we ask those who know you best, what would they say about your emotional stability and consistency? *

How do you handle confrontation? *

Why are you interested in working with CLCC's MOSAIC ministry? *

Tell us about your volunteer history...

Please list the date and activities of other ministry experiences that you have been involved in here at CLCC. What were your reasons for ending that ministry? *

Serving in CLCC's ministries takes time and commitment. We want leaders who will make their ministry a priority. What does commitment mean to you? *

Is there anything else?

Is there anything else that you feel we need to know about you? *

MOSAIC Volunteer Areas *

Here's a list of all of the areas that you can become involved in our MOSAIC ministry. Please select the areas that interest you:

ESL Cooking Circle

ESL Conversation Club

ESL Bible Study

References

You must provide 2 NON RELATED references (ie: a friend, co-worker, fellow volunteer, supervisor, previous church Pastor) who can testify to your commitment to Christ and the accuracy of the life testimony you have provided in this application. Please ask your references to complete the online forms provided on the MOSAIC ministry page on CLCC's website.

Reference #1 *

Name, Email & Phone Number:

Reference #2 *

Name, Email & Phone Number:

Information Disclosure

I confirm that: *

The information contained in this application is correct to the best of my knowledge. I give authorization to Christian Life Community Church or its representatives to release any and all records or information relating to work with the vulnerable population. CLCC may contact my references and appropriate government agencies as deemed necessary in order to verify my suitability as a volunteer. I also understand that the personal information will be held confidential by Christian Life Community Church and its staff. Please confirm the above statement:

Next Steps:

Please check your email folders (including spam) for important instructions with links to complete the Plan for Protection and FREE criminal record check.

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