Catalyst Church | Woodland, CA - Background Check Form

Full Legal Name

Gender
Male
Female

Date of Birth

Phone Number

Email Address

Present Address Line 1

Address Line 2

Country

City

State

Zip/Postal Code

Prior Address Line 1 - (if at present address less than one year)

Address Line 2

Country

City

State

Zip/Postal Code

Social Security #

Driver's License #

Driver's License Expiration

In caring for people at Catalyst, we believe it is our responsibility to seek volunteers who are able to provide healthy, safe, and nurturing relationships. Please answer the following questions accordingly. Please understand that others on the Catalyst Staff may review the information provided in this application. Any special concerns will be discussed individually with the Catalyst Staff.

Have you ever been accused or convicted of the use or sale of illegal drugs?
Yes
No

Have you ever been charged with a misdemeanor or felony?
Yes
No

Do you have any health issues that could place anyone at Catalyst at risk?
Yes
No

Have you ever been accused or convicted of any type of misconduct with a minor?
Yes
No

Have you ever been denied legal custody of your child/children in any legal proceeding, including divorce decrees or settlements?
Yes
No

Do you have any objections to an FBI and DOJ background check?
Yes
No

If you answered YES to any of the above questions, please explain briefly:

Applicants Statement of Release

I hereby authorize Catalyst to verify all information contained in this application. I hereby authorize any individuals to disclose any and all information to Catalyst. I release all such persons or entities from liability that may result or arise from Catalyst's collection of all information or its consideration of my application.
Agree
Disagree

I also grant the leadership of Catalyst permission to make any and all inquiries regarding my application for a volunteer position in Catalyst. I grant permission for any representative of Catalyst to share any information they believe may impact a decision for the volunteer position I am applying for. This release is in effect for 90 days from the date I submit my application to the Catalyst staff.
Agree
Disagree

Should my application be accepted, I agree to refrain from un-biblical conduct in the performance of my service on behalf of the church. I certify that the above information and statements are true and complete to the best of my knowledge. I understand the personal information provided in this application will be held confidential by the Catalyst staff.
Agree
Disagree

Applicant's Online Signature **Please place a forward slash /before and after your name/, to indicate your signature**

Date

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We Live Like JesusIn CommunityOn Mission

Sunday Morning Service Times

Contact Us

Follow Us

We Live
Like Jesus
In Community
On Mission