Safety Team

This Form is for new serve team members wanting to serve on the Safety Team.

Your name *

Email address *

Phone number

How long have you been attending Breath of Life Church? *

On what other ministry teams are you or have you served at Breath of Life Church? *

Why do you want to serve on the Safety Team? *

What skills and attributes would you bring to the Team? *

Describe any formal training or certifications you have completed or currently undertaking related to this role: *

What other safety- or security- related work experience do you have? (please list) *

Organization, Program, Dates (from-to), Contact Name and Phone/Email

Have you ever been accused, arrested or convicted of any crime? *

Have you ever been investigated? *

Have you ever been investigated by a state or federal agency for misconduct? *

Have you ever lost or been denied the privilege to carry a concealed weapon? *

Have you ever had any life experiences that have better equipped you for or may hinder you from a productive ministry on the safety team? *

Have you ever been dismissed from a ministry team? *

If the answer to any of the questions above is “yes,” please explain in detail: *

What church or churches have you attended in the past 10 years? *

Church Name, City & State, Pastor's Name

Have you served on any church safety/security teams in the past 5 years? *

References (other than relatives). Please provide at least two *

Name, Relationship, Phone Number, and Email Address

Certify *

I recognize that Breath of Life Church is relying on the accuracy of the information I provide on this application form. Accordingly, I attest and affirm that the information I provided is absolutely true and correct. I authorize Breath of Life Church to contact any person or entity listed on the application form, and I further authorize any such person or entity to provide Breath of Life Church with information, opinions, and impressions relating to my background and qualifications. I voluntarily release Breath of Life Church and any such person or entity listed on the application form from any liability involving the communication of information relating to my background and qualifications. I further authorize the organization to conduct a criminal background investigation if such a check is deemed necessary. I agree to abide by all policies and procedures of Breath of Life Church and the Breath of Life Church Safety Team and to protect the health and safety of the people assigned to my care or supervision at all times.

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