ELC Application. Personal Information Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### Social Security # This information can also be given by calling our office. Date of Birth * MM DD YYYY Current Grade * 10 11 12 Other Are you a legal resident of the U.S.? * Yes No PERSON TO BE NOTIFIED IN CASE OF ACCIDENT OR EMERGENCY Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### POSITION(S) APPLIED FOR Please select all areas that interest you. Team Ministries: * Audio Technician Singer Pianist Children Ministries Secretary Drama Maintenance Hospitality PLEASE WRITE ANY INFORMATION OR SHARE ANY TALENTS/INTERESTS YOU HAVE THAT MIGHT BE HELPFUL AS WE CONSIDER YOU FOR THIS POSITION HEALTH Do you have any physical or mental conditions which may limit your ability to perform the ministry for which you have applied? * Yes No If Yes, please explain Insurance Company * Policy # * PERSONAL INFORMATION Do you now or have you ever used any narcotics, hallucinogens or drugs not prescribed by a physician? * Yes No If Yes, what kind and when? Do you now drink alcoholic beverages? * Yes No Do you now smoke? * Yes No Have you ever been convicted of a felony? * Yes No If Yes, give details of the case Have you ever been accused of, participated in, or been convicted of sexual abuse with a minor? * Yes No Are you willing to give up any social habits that would lessen your effectiveness and your influence as an Encounter Staff Member? * Yes No BIOGRAPHICAL INFORMATION SALVATION * State how and when you became a Christian, evidence of your growth in Christ, and what He means to you. CHRISTIAN SERVICE * Describe any full-time or part-time Christian service you have performed. Include the name and denomination of your home church and state how many years you have attended this church. Calling: State the reasons why you believe God is leading you to serve with ERM. REFERENCES List three references, including pastor, spiritual leader, and someone acquainted with your qualifications in your specific area of service. 1. Pastor Name * First Name Last Name Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email Business Associate, College Professor or School teacher Mr. Mrs. Miss Name * First Name Last Name Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Other Mr. Mrs. Miss Name First Name Last Name Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email PARENT’S STATEMENT We have reviewed the application? * Yes No Our response to this opportunity is * Parent's Email Address * DECLARATION AND AGREEMENT STATEMENT OF FAITH (DO NOT LOSE YOUR PROGRESS - RIGHT CLICK LINK AND OPEN IN NEW TAB) Do you agree with ERM's Statement of Faith? * Yes No Digital Signature * I agree that this electronic signature is the legal equivalent of my manual signature. Date * MM DD YYYY Thank you for applying to the ELC Team. Someone will contact you shortly.
