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Leader's Corner

New Life Church

Group Ministries Department

11025 Voyager Pkwy
Colorado Springs, CO 80921

Phone- 719-265-3116
Fax- 719-548-9000

info@newlifegroups.com

Part 1

Vital Information
Name: Birthdate: Gender:
Address: Email:
City: State: Zip:
Home Phone: Work Phone:
How long have you lived in Colorado? Other states you have lived in:

Are you able, with or without accommodation, to perform the essential duties described for the volunteer position of Small Group Leader?
If not, please explain:

Have you attended a New Leader Orientation? If so, when?
If you haven't attended the orientation you can sign up here

Marital Status: Single Engaged Married Divorced Widowed
Spouse: Birthdate:
Years Married: Anniv. date:

Children:
Name: Age: Birthdate:
Name: Age: Birthdate:
Name: Age: Birthdate:
Name: Age: Birthdate:

Part 2

Church History & What You Believe
How long have you regularly attended New Life Church? Do you tithe regularly?
Have you attended New Life all of your life?
Information on previous church attended:
Name of church: City/State of church:
How long did you attend this church? Name of pastor:
Are you a born again Christian? When did you become one?
When did you receive the Baptism in the Holy Spirit?

Please check the statements that apply to you. I believe….
I Agree with all the below
The virgin birth and deity of Jesus Christ
That Jesus is God’s Son and only sacrifice for sin
That Jesus rose bodily from the dead
That a person must be born again to receive eternal life
In the infallibility of the Holy Bible
In eternal damnation for the lost

Formal Education

Institution	Degree Earned	Year Graduated

Presently a student: Time Year:
School:

Employment History (Please list chronologically, starting with most current position.)

Position Held	Employer	Date	Full or Part-Time

Ministry-Related Experience (List any previous ministry-relatedr small group ministry experience.)

Position	Ministry	Paid/Unpaid	Date

What area do you most want to lead a group in?

About Yourself

Special Interests & Talents
teaching	assistant to leader	visitor follow up
crafts/sewing/painting	creative writing	new believer follow up
praise & worship	outreach	clerical skills
carpentry	greeter	providing refreshments
sound & media	drama	recruiting volunteers
story telling	musical instruments	organizing volunteers
intercessory prayer	publication/newsletter	games & recreation

List three STRENGTHS	List three WEAKNESSES
1.	1.
2.	2.
3.	3.

Where Is Your Passion For Ministry?
Adults	Bible teaching	Children	Prayer
Men	Special Needs	Families	Generations (Srs.)
Women	Helps	Parenting	Recreation & Activities
Youth	Praise & Worship	Singles	Other:

Briefly explain why you would like to be a small group leader :

Background Information
Has anyone ever brought or threatened to bring a civil or criminal claim against you alleging physical or sexual abuse or sexual harassment?
Have you ever been charged, arrested, or convicted of a felony or misdemeanor?
Have you ever terminated your employment or had your employment terminated or has your employer ever reprimanded you for reasons relating to allegations of physical or sexual abuse or sexual harassment by you?
Have you ever been reprimanded as a student for harassment of another individual or other inappropriate behavior with another individual?
Is there anything in your past that might come up as a questionable issue?
If yes, please explain?

Part 3

References (Please provide the name of two personal references (exclude family members), and one pastoral or ministry supervisor reference.)

	Reference #1	Reference #2	Reference #3
Name
Relationship			Pastor or ministry supervisor
Phone
State
Email

Part 4 NEW LIFE CHURCH REQUEST AND AUTHORIZATION FOR CRIMINAL and BACKGROUND RECORDS CHECK

I understand that New Life Church will seek and obtain investigative reports about me as defined in the Fair Credit Reporting Act (FCRA). These investigative reports may include, but are not limited to criminal history records (from local, state and federal agencies), sexual offender's lists, wants and warrants records, and motor vehicle records. I hereby authorize, without any reservation, the full release of these records from such agencies and hereby release such agencies from any liability resulting from disclosure of this information. In addition, I release and discharge New Life Church from any expenses, losses, damages, and liabilities for the investigative process. Upon request, New Life Church will supply a copy of my reports and my rights under the FCRA. Requests may be directed to: New Life Church, Attention: HR Department, 11025 Voyager Parkway, Colorado Springs, CO 80921 or by contacting New Life Church at 1-719-594-6602.

I hereby authorize New Life Church to conduct a criminal and background records check through the appropriate national, state, and county agencies and for such agencies to release any information which pertains to any record of convictions contained in its files or in any criminal file maintained on me whether state, local, or national. I hereby release said agency from any liability resulting from disclosure of this information.

Signature: Date:
Full Name: Maiden Name:
Year Married: All Aliases (Last Name Only):
Date of Birth: