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PCC Kids Get To Know You Form

This form is for all volunteers involved in the supervision and teaching of minors in PCC Kids. Information will be treated as confidential and is needed to help us provide a safe environment for children.

Step 1 of 4

25%

General Info
Name*
First Middle Last
Phone*
Ok to text you?*
- Yes
- No
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*

* We primarily communicate through email.
Birthday
Marital Status
Spouse's Name (if applicable)
Anniversary Date
If applicable, is your spouse involved in a ministry team at PCC? If so, where and in what role?
Names of children and ages
What campus do you attend?*
Where would you like to volunteer at your campus? (Select all that apply)*
Please visit link at the top of this page for a list of positions and descriptions.
- Babies/Toddlers
- Preschool age 3
- Preschool age 4
- Preschool age 5
- Kindergarten
- Primary Elementary (1st – 3rd)
- Middle Elementary (4th-5th)
- Special Buddies
- PCC Kids Greeters or Check-in
- Worship Leaders
- Tech Team (sound, lighting, computer)
- Drama (hosts, actors, storytellers)
- Set Design/ Decor
- Admin Assistants (behind the scenes during the week)
- Other
If Other, please list interests:
Which service do you typically attend?*
When are you available to serve? (Select as many as are applicable if you are willing to serve for more than one service on a Sunday)*
- 8:30am
- 10:00am
- 11:30am

PLEASE READ:
In PCC Kids, we have some roles that include recurring spiritual authority (leaders and teachers), and some roles that do not. As leaders and teachers, those you lead and teach will watch you closely and take your words seriously. Because of that, we ask that those in a leading and teaching role agree to a Leaders’ and Teachers’ Covenant. Specifics will be discussed during the new server orientation. If you have any questions beforehand, please talk with the Kids Coordinator for your campus.
Background
How long have you been attending PCC?*
Which church did you previously attend, if any?*
Have you accepted Jesus Christ as your Lord and Savior?*
Have you been baptized?*
Are you a member of PCC?*
This means that you have completed Belong 101 (previously PCC 101), turned in a signed Membership Covenant, and that you’ve been baptized, either previously or at PCC.
Are you in a small group?*
PLEASE NOTE:
The questions below are a part of our application process in order to provide a safe and secure environment for our children/youth, and are not designed to offend or pass judgment. Rather, they are intended to create an environment where a person’s past will not hinder the ministry in carrying out their mission in a safe, fun and productive way. Answering yes to any of these questions does not necessarily preclude your involvement in ministry.
Have you ever been convicted of a crime?*
- Yes
- No
If yes, please explain…
Have you ever been accused, arrested, or convicted of child abuse, neglect, a crime involving a minor, or another sexually related crime?*
- Yes
- No
If yes, please explain…
Are there any circumstances involving your lifestyle or your background that would call into question your ability to work with children?*
- Yes
- No
If yes, please explain…
Have you had any painful experiences in your life that have better equipped you or that may hinder you from a productive ministry with children?*
- Yes
- No
If so, would you like to talk to a pastor regarding this experience?
- Yes
- No

Training/Experience
Do you have any medical training or are you CPR certified?*
- Yes
- No
If yes, please provide detail if you wish.
Please list any gifts, talents, training, skills, experience, or education that has prepared you to work with children:*
Are you involved in any other ministries at PCC?*
- Yes
- No
If so, please describe.
Do you have any physical handicaps or conditions that might prevent you from certain types of activities?*
- Yes
- No
If yes, please describe.
Passions and Strengths
What seems to motivate you the most?*
- a word of appreciation
- a small appreciation gift
- someone doing something for you
I think I'm really good at:*
I am not so good at:*
For Fun 🙂
Favorite Color(s):*
Favorite Candy:*
Favorite Drink:*
Things I really like:
Things I really don't like:

References
Please provide the names of three individuals (not relatives) who have known you for at least 2 years. If you are under the age of 18, you may use the name of a parent and/or teacher. If possible, please include at least one reference from someone here at PCC. All people listed as references should be informed that you have listed them.
Reference #1
Name*
First Last
Relationship:*
Phone*
Email
Reference #2
Name*
First Last
Relationship:*
Phone*
Email
Reference #3
Name*
First Last
Relationship:*
Phone*
Email

Passion Community Church

4480 Anderson Hwy,
Powhatan, VA 23139

info@pccwired.net

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Aylett
Buckingham Prison
Farmville
Midlothian
Online
Powhatan
Riverside
VCCW Prison

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