EmailMe Form - Safety/Security Volunteer Application

Personal Information:

Name *

First Last Suffix

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Date of Birth *

MM / DD / YYYY

Gender *

Male

Female

Phone Number *

### - ### - ####

Email *

CBC Status *

Select 1 Option

Team/Availability:

Team Request *

Watch Team

Medical Team

Camera Team

Response Team

Check all that Apply

Shift Preference *

0830-1030 First Sunday Service

1015-1215 Second Sunday Service

Wednesday Night

Check all that Apply

I have experience in the following: *

Select all that apply

Concealed Carrier Weapon Card holder? *

Yes

No

Looking to in the future!

If "YES", please see Security Director!

References:

Name *

First Last

Email *

Phone

### - ### - ####

Name *

First Last

Email *

Phone

### - ### - ####

Background Check:

All prospective Security Team Members will require a background check prior to being accepted. Use the link below to complete the background check application, in addition to completing this volunteer application. Select the "Security Ministry Volunteer" option. If you have an issue or question about completing the background check, please email your question to security@cbcva.org.

Did you complete a Background Check Application? *

Yes

No

The Background Check Application Website is:
HTTPS://BIB.COM/SECUREVOLUNTEER/CENTREVILLE-BAPTIST-CHURCH/

If "NO", please email Security Director: security@cbcva.org

Director of Security

Jeff Thorpe
jeff.thorpe@cbcva.org
(240)-462-3106

I certify that information contained in this application is true and complete. I understand that false information may be grounds for removal from volunteer service at any point in the future. I authorize the verification of any or all information listed above.

Do you agree with the terms and conditions? *

Yes, I agree.

Initial *

Date *

MM / DD / YYYY