Please fill out the background check form below. Once you have completed the form, please sign and submit at the bottom of this page.

I authorize Clements Baptist Church to conduct an independent investigation of my driving record (MVR), background, references, character, credit, employment, police and criminal history record information pertaining to me which may be in any state or local criminal justice agency in the United States, workman’s compensation and all public records for the purpose of confirming the information contained on my application, or other supporting information which may be relevant to my qualifications for working with minors at Clements Baptist Church.

I release Clements Baptist Church and/or its agents and any person or entity that provides information pursuant to this authorization from any and all liabilities, claims, or law suits in regards to the information obtained from any and all of the above referenced sources used. I further understand that Clements Baptist Church and its agents will adhere to applicable state and federal statutes concerning the securing of information, handling, and release of information obtained-in the pre-employment investigation.

The following is my true and complete legal name. All information on this document is true and correct to the best of my knowledge:
BG Check Form
All Other Names Ever Used (Include Maiden Name and Names from Previous Marriages): Applicants are requested to put the approximate years of each name used to insure that the correct name is used at each previous location. Otherwise, the verification process may be delayed because the employer/education cannot be verified.

Please provide 7 Year Address History Below:

Confidential Volunteer Worker Application Form
This application is completed by all volunteers for any position involving the supervision or custody of minors. It will help our church provide a safe and secure environment for preschoolers, children, and youth who participate in our ministries.


Do You Have A Driver's License?
Have you ever been charged with, indicted for, or pled guilty to an offense involving a minor?
Were you a victim of abuse or molestation while a minor? {If you prefer, you may refuse to answer this question. Or you may discuss your answer in confidence with one of the ministers rather than answering it on this form. Answering yes or leaving the question unanswered will not automatically disqualify you.)
I will not give even the appearance of evil, particularly by abstaining from alcoholic beverages and all tobacco products, gambling, and other like activities that would harm my testimony and witness of Christ. Which would include living in a Biblical relationship whether married or single.