Personal Information
Name *
Name
(optional)
Birth Date *
Birth Date
Address *
Address
Would you like to receive email updates? *
Home Phone
Home Phone
Cell Phone
Cell Phone
Marital Status *
Anniversary Date
Anniversary Date
Spouse's Name
Spouse's Name
Spouse's Birth Date
Spouse's Birth Date
Would he/she like to receive email updates?
Spouse's Phone
Spouse's Phone
Alternate Address
(i.e snowbirds)
Date From
Date From
Date To
Date To
Address
Address
Emergency Contact (other than spouse)
Name *
Name
Phone *
Phone
Children (under 18 and living at home)
Name
Name
Birth Date
Birth Date
Name
Name
Birth Date
Birth Date
Name
Name
Birth Date
Birth Date
Name
Name
Birth Date
Birth Date
Name
Name
Birth Date
Birth Date
Name
Name
Birth Date
Birth Date
SPIRITUAL LIVING
Indicate one or two choices of ministry you would like to serve in. *
Sunday Service Preference
Authorization for Release of Background Information
PLEASE BE ADVISED: If you are 18 years or older, by typing your name and dating below, you release authorization for us to run a PROTECT MY MINISTRIES background check.
In connection with my application for volunteer service with RLC-Cadillac, I authorize RLC-Cadillac and/or PROTECT MY MINISTRIES, their agent to solicit background information relative to my criminal record history. I understand that RLC-Cadillac may conduct inquires into my background that may include criminal records, personal references, and other public record reports pertaining to me.
I AUTHORIZE WITHOUT ANY RESERVATION, ANY PERSON, AGENCY, OR OTHER ENTITY CONTACTED BY RLC-CADILLAC OR PROTECT MY MINISTRIES, THEIR AGENT FOR PURPOSES OF OBTAINING BACKGROUND REPORT INFORMATION, TO FURNISH THE ABOVE MENTIONED INFORMATION.
I release RLC-Cadillac, their respective employees or PROTECT MY MINISTRIES, their agents, employees, and all persons, agencies and entities providing information or reports about me from any and all liability arising out of furnishing any such information or reports.
Applicant's Signature
Applicant's Signature
Date
Date
Guardian's Signature
Guardian's Signature
(if applicant is a minor)
Date
Date