ࡱ> 02/ Nbjbjvv (N eeee q@."iD˔TeF5 0=,T T iiee s:   New Covenant Christian Community 21 East Broad Street, Bethlehem, PA 18018 Occasional Child/Youth Worker Application Form Name _____________________________________________________ Date ___________________ (please print) Address ___________________________________________________________________________ Phone ______________________________________ Email _____________________________ The following policies reflect our commitment to provide protective care of all children, youth, and volunteers who participate in church sponsored activities. All adult volunteers and staff shall confess Jesus Christ as their personal Lord and Savior, be a member in good standing and attendee of NC4 for at least six months. Adults who have perpetrated and/or been convicted of either sexual or physical abuse of a child or children will not be permitted to serve as volunteers in any church-sponsored activity or program for children or youth. a) Have you ever perpetrated any of these crimes? Yes______ No______ b) Have you ever been accused of any of these crimes? Yes______ No______ c) Have you ever been convicted of any of these crimes? Yes______ No______ Adult volunteers and staff are to observe the two adult rule. This requires that adults make every reasonable effort to avoid being in an isolated setting with children or youth without another youth/child Worker. Volunteers or staff are to immediately report to the Overseeing Elder any behavior which seems abusive or inappropriate or any incident reported by a child or adolescent. When an allegation of abuse is brought to the attention of the staff, it will be reported to outside authorities (ChildLine and/or the Police). The volunteer or staff member accused will be informed that he/she may not minister to children or adolescents at NCCC during the investigation. Do you have any questions about these guidelines? Yes _______ No _______ As a church volunteer, do you agree to observe all church guidelines regarding working with youth or children? Yes _______ No _______ Do you have any personal history of abuse (of any kind) that you feel would prevent you from complying with these guidelines working with children or reporting child abuse? Yes _______ No ________ Are you willing to attend a training course(s) to become familiar New Covenants Child Sexual Abuse Prevention Guidelines? (This is not mandatory for Occasional Child/Youth Workers) Yes _______ No _________ Signature _____________________________________________ Please return to Tony Piergiovanni, Administrative Pastor All Forms are kept CONFIDENTIAL !y     6 = ? H I L M _ h n o tXwMNh5CJOJQJaJh ^h5h ^h5CJaJh2h5h N ^`gd &d P gd ^`gdgd & Fgdh^hgd&1h:p/ =!"#8$%6666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ LNormalCJ_HaJmH sH tH DA D Default Paragraph FontRiR  Table Normal4 l4a (k (No List HH G Balloon TextCJOJQJ^JaJPK!K[Content_Types].xmlj0Eжr(΢]yl#!MB;BQޏaLSWyҟ^@ Lz]__CdR{`L=r85v&mQ뉑8ICX=H"Z=&JCjwA`.Â?U~YkG/̷x3%o3t\&@w!H'"v0PK!֧6 _rels/.relsj0 }Q%v/C/}(h"O = C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_6LR7`0̞O,En7Lib/SeеPK!kytheme/theme/themeManager.xml M @}w7c(EbˮCAǠҟ7՛K Y, e.|,H,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+& 8PK!\theme/theme/theme1.xmlYOoE#F{o'NDuر i-q;N3' G$$DAč*iEP~wq4;{o?g^;N:$BR64Mvsi-@R4Œ mUb V*XX! cyg$w.Q "@oWL8*Bycjđ0蠦r,[LC9VbX*x_yuoBL͐u_. DKfN1엓:+ۥ~`jn[Zp֖zg,tV@bW/Oټl6Ws[R?S֒7 _כ[֪7 _w]ŌShN'^Bxk_[dC]zOլ\K=.:@MgdCf/o\ycB95B24S CEL|gO'sקo>W=n#p̰ZN|ӪV:8z1f؃k;ڇcp7#z8]Y / \{t\}}spķ=ʠoRVL3N(B<|ݥuK>P.EMLhɦM .co;əmr"*0#̡=6Kր0i1;$P0!YݩjbiXJB5IgAФ޲a6{P g֢)҉-Ìq8RmcWyXg/u]6Q_Ê5H Z2PU]Ǽ"GGFbCSOD%,p 6ޚwq̲R_gJSbj9)ed(w:/ak;6jAq11_xzG~F<:ɮ>O&kNa4dht\?J&l O٠NRpwhpse)tp)af] 27n}mk]\S,+a2g^Az )˙>E G鿰L7)'PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-!K[Content_Types].xmlPK-!֧6 1_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!\theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] N !K|}:;01Ino=>  P 0000000000000 00 00000 00 00 0""""""""""""""""""""""""N n N P P P ;C} P 33333{A:X^`.^`.pLp^p`L.@ @ ^@ `.^`.L^`L.^`.^`.PLP^P`L.{A:         P @N P@UnknownGTimes New Roman5Symbol3 ArialSArial Rounded MT Bold5& *[`)Tahoma"qh{F{}!824o N 2QHX)? 2 New Covenant Christian Community Philip Smith  Oh+'0 (4 T ` l x'$New Covenant Christian Community  Normal.dotmPhilip Smith4Microsoft Word 12.1.2@F#@Z@LrZ@T} ՜.+,D՜.+,P  hp  'NCCCo  !New Covenant Christian Community TitlelH(DX`_AdHocReviewCycleID_EmailSubject _AuthorEmail_AuthorEmailDisplayName_PreviousAdHocReviewCycleID_ReviewingToolsShownOnce'ԒOccasional Worker FormDenise.Horn@nc4.org Denise HornUg  !"#$%&()*+,-.1Root Entry FpD˔T31Tabled WordDocument(SummaryInformation(DocumentSummaryInformation8'CompObj` F Microsoft Word 97-2004 DocumentNB6WWord.Document.8