Mail completed application to the address above ATTN: Chris Cook or Fax to
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1 Application for Leadership in Care Ministries Crisis Care Team (Stephen Ministry) Kensington Community Church, 1825 E. Square Lake Road, Troy, MI Mail completed application to the address above ATTN: Chris Cook or Fax to The desire of Kensington Community Church is to provide the safest and most secure environment for people entrusted to our ministry. This application is to be fully completed by everyone who wants to lead on the Crisis Care Team. Although a criminal records check is required only for leadership in certain areas of Care Ministries, general information and authorization for criminal records check is mandatory for every individual who applies. We re not looking for perfect people just honest people. Please Print or Type: Campus you attend: Birmingham Clinton Twp Florida Orion Shelby Twp Troy Application Date Print First Middle Initial Last Maiden or Aliases Address Street City State Zip Best phone number to contact you (w/area code) Address Date of Birth Place of Birth Occupation Marital Status: Single Divorced Widowed Married Engaged (Fiancé s ) (Spouse s ) Membership Status: Active Member Regular Attendee How long? OFFICE USE ONLY Reference checks Background check Approved? Application for Leadership in Care Ministries: Crisis Care Team 1
2 MINISTRY INFORMATION In what areas have you served at Kensington? Please list where you have served and the dates: List all non-church related experiences involving outreach to people in crisis: List any experience, training, education, or other qualifications that have prepared you for Compassion work. Why do you want to serve on the Crisis Care Team? Please summarize how you became a Christian and describe your present spiritual life: Application for Leadership in Care Ministries: Crisis Care Team 2
3 PERSONAL REFERENCES List three people you have known for at least one year, who are not related to you and have a definite knowledge of your character. Include an individual who also attends Kensington Community Church even if they haven t known you a year, e.g. the person who led you to volunteer in Compassion Ministries?). Ministry at KCC? / Best phone to reach this person / Ministry at KCC? / Best phone to reach this person / Ministry at KCC? / Best phone to reach this person / Are there any other areas where you feel called to minister? Application for Leadership in Care Ministries: Crisis Care Team 3
4 PERSONAL HISTORY Please understand that many have been strengthened in their relationship with Christ through the trials of their life. These trials do not necessarily disqualify you from serving. We simply need to have the fullest under-standing of your past and how it affects your ministry in the present. If any one of the next few questions is answered yes, please explain as necessary in the space provided. Your in-person interview will be an opportunity to discuss any of these issues. Has there been alcohol abuse, drug abuse, physical or sexual abuse in your life or your family background? yes or no If yes, please list and describe what steps have you taken to reconcile the impact that those issues have created for you? Have you ever been arrested, convicted or pled guilty to a crime? yes or no Have you ever been accused of or had a verdict rendered against you in civil court in relation to any sexual molestation, abuse or negligence of a minor? yes or no If yes, explain in detail, providing date and place of incident. Is there any circumstance or pattern in your life that would make it inappropriate for you to serve or would compromise the integrity of Kensington Community Church (e.g. pornography, gambling, homosexuality, promiscuity, cohabitation or any other life style choice)? For further clarity, please review Leader s Gut Check (attached) yes or no If yes, explain in detail, providing date and place of incident. Have you received any kind of professional care/counseling in past at any time? yes or no If yes, explain. If yes to any of the above, someone from the Stephen Leader team will speak to you about this so that the team may better understand its significance in your life and ministry. Note: A great many caregivers have been made stronger in their care giving ministry through the care they themselves have received, including care from mental health professionals. Your Stephen Leader Team affirms the work of mental health professionals who have helped many individuals to experience growth and healing. Members of the Stephen Leader Team request this information because they want to be as fully informed as possible about their Stephen Ministers. Application for Leadership in Care Ministries: Crisis Care Team 4
5 STEPHEN MINISTRY DETAILS 1. Have you ever trained and served as a Stephen Minister or Stephen Leader at another congregation? If yes, please list where and when. Please include the name and telephone number of a pastor and/or Stephen Leader there whom we can contact. Phone 2. Have you received care from a Stephen Minister? yes or no If yes, please list where and when the care relationship ended 3. Are you willing to commit to serve faithfully for a period of no less than two years? This includes: The initial 50 hours of training? yes or no Regular visits to your care receiver? yes or no Twice a month Small Group Peer Supervision yes or no Three per year Continuing Education Classes? yes or no 4. What changes would you need to make in your life in order to fulfill this commitment? APPLICANT S STATEMENT The information contained in this application is correct to the best of my knowledge. I authorize any references listed here to give Kensington Church any information (or opinions) that they may have regarding my character and fitness to serve in Care ministries. In consideration of the receipt and evaluation of this application by Kensington Church, I hereby both collectively and individually, release from any and all liability for damages of whatever kind of nature which may at any time result to me, my heirs or family, on account of compliance or any attempts to comply with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization in this application. Should my application be accepted, I agree to refrain from unscriptural conduct in the performance of my services on behalf of Kensington Church. I hereby request and authorize the release of information, which pertains to any records or convictions contained in law enforcement files or in my criminal file maintained on me whether local, state or national. I hereby release local, state and national law enforcement agencies from any liability resulting from such disclosure. I further state that I have read the foregoing release and know the contents thereof and sign this release as my own free act. This is a legally binding agreement which I have read and understand. Applicant s Signature Date Applicant s Printed Application for Leadership in Care Ministries: Crisis Care Team 5
6 LIFESTYLE COMMITMENT STATEMENT FOR MINISTRY LEADERS I understand that by participating in I am voluntarily submitting and entering into relational and spiritual accountability with my team members and its leaders. I also understand that my role in this ministry is considered a leadership position at Kensington. The role of leadership brings with it a tremendous amount of personal and spiritual responsibility. I agree to wholeheartedly embrace my role on this team and to conduct myself in a manner that is consistent with a lifestyle that reflects the character of Christ and the expressed values of Kensington Community Church. I will refrain from any lifestyle choices and behaviors that would be a poor reflection on myself, my team, my church and ultimately Jesus Christ. I will seek to live a life that will not hinder others in their spiritual development and will avoid lifestyles that involve destructive, addictive behaviors such as, but not limited to, excessive drinking, substance abuse, and sexual sins such as sex outside of marriage, adultery, and pornography. (Kensington believes the Bible reserves all sexual activity for the marriage relationship between one man and one woman.) I will also avoid relationally destructive behaviors such as dishonesty, gossip, an un-teachable heart, or an unforgiving spirit. Any member who demonstrates an ongoing pattern with these issues or any other issues that would cause embarrassment to the name of Christ and/or disunity to our team, will be asked to step off of their ministry team. This step is not intended to penalize or punish individuals, but to allow them to go through a process of healthy restoration so that they can potentially return to leadership and be a Godly example to others in good conscience. Kensington realizes that there could be differing opinions on what is and is not acceptable Christian behavior and practice. In these instances, Kensington will clearly outline their position on issues that may be controversial in nature. I understand the above explanation and agree to participate wholeheartedly under these guidelines. Signature Date Application for Leadership in Care Ministries: Crisis Care Team 6
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