Family Ministry Nursery/Childcare Application

	Please fill out this Childcare Application, hit submit and someone will contact you shortly. *Full Name: *Date of Birth: *Address: *City: *State: AR LA OK TX *Zip: *Home Phone: Cell Phone: Work Phone: E-Mail: *Marital Status: Single Married Spouse's Name: *Occupation: *Place of Employment: *Social Security Number: *Briefly describe when and how you accepted Jesus Christ as your personal Savior.: Are you a member of Macedonia Baptist Church?: No Yes *Denomination and name of church: *Pastor and church or Pastor's phone #: *Please list all areas of previous experience in Sunday School or other church leadership position.: *Please list any current areas you are serving at Macedonia Baptist Church: *Please list any recent training which has contributed to your growth as a Christian or leader: Have you ever been convicted of or pleaded guilty to a crime?: No Yes REFERENCES: Professional or business associates (not relatives) who know you well whom the church may contact. *(Including one in ministry) *Reference #1 (Name/Address/Phone): *Reference #2 (Name/Address/Phone): *Reference #3 (Name/Address/Phone): *Reference #4 (Name/Address/Phone): By signing my name below, I give Macedonia Baptist Church the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability Macedonia Baptist Church and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information *Signature/Date: Have you had an interview?: No Yes