Background Check Form

Background Check Form
Date

Month Day Year
Date Hour Minutes AM/PM Option
Please Check all Organizations you will be volunteering with *

Spring Hills Baptist Church Look Up Center
Personal Information
Name *

First Name Middle Name Last Name
Date of Birth *

Month Day Year
Social Security Number *
Gender *

Male Female
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *
Phone Type *

Mobile Home
Email *
example@example.com
Are you a Member/Attender at Spring Hills Baptist Church? *

Yes No
How long have you been attending SHBC? *
Do you have a Home Church? *

Yes No
Church Name *
Church Reference Name *

First Name Last Name
Reference Phone Number *
Reference Email *
example@example.com
Occupation *
Employer *
What Ministries will you/are you involved with? (Please check all that apply) *

Children's Ministries (AWANA, Kids Choir, Kids Korner, Gear Up, Homeschool Ministry, VBS, etc.) Youth Ministries (Amplify, Uth, Homeschool, Gear Up, Skyview Ranch) Missions Cafe Book Room Ministry Offering Counter Van Ministry Safety & Security Sonshine Preschool Granville Christian Academy SHBC Staff
Personal History
Have you at any time ever:
Been arrested for any reason? *

Yes No
Been convicted of, or pleaded guilty or no contest to any crime, other than a moving traffic violation? *

Yes No
Engaged in, or been accused of, any child molestation, exploitation, or abuse? *

Yes No
Are you aware of:
Having any traits or tendencies that could pose any threat to children, youth, or others? *

Yes No
Any reason why you should not work with children, youth, or others? *

Yes No
If the answer to any of these questions is "yes", please explain in detail:
Driving information
Do you have your own transportation? *

Yes No
Do you have a valid driver's license? *

Yes No
Driver's License Number *
State of Issue *
Picture of Driver's License

Browse Files

Cancel of
Do you have a Vehicle Liability Insurance? *

Yes No
Vehicle Liability Insurance Card

Browse Files

Cancel of
Applicant's Name *

First Name Last Name
Applicant's Signature *

Clear
Should be Empty:

Background Check Form

Personal Information

Personal History

Driving information