1.
PLEASE PRINT OR TYPE
FULL LEGAL NAME ____________________________________________________________________
Last First Middle
Name you go by: __________________________ Home Phone: ____________ Cell: _________________
(If selected for the Team, this name will be put on your name badge) Do you text? _________________
Address: _______________________________________________________________________________
Street City State Zip
E-Mail Address: __________________________________________________________________________
Date of Birth: _____/_____/_____ Age as of June 1, 2010: ____________ Sex: Male Female
PARENTS:
Father’s Name: ________________________________ Mother’s Name: __________________________
Address: _______________________________________________________________________________
Street City State Zip
Parent’s Home #: _____________ Parent’s Work #: _______________ Parent’s Cell #: _______________
Parent’s E-Mail Address: __________________________________________________________________
CHURCH:
Do you regularly attend Oregon City Evangelical Church? Yes No
SCHOOL:
School Name (currently attending): ___________________________________________________________
Current year in School: ___________________________________________________________________
EMERGENCY: In case of emergency or accident, whom should we notify?
Name: _________________________________________ Relationship: __________________________
Address: _______________________________________________________________________________
Street City State Zip
Phone: ___________________________________ Work Phone: _____________________________
Insurance Company: __________________________________ Policy #: ___________________________
Medical allergies, medications being taken, medical problems or other pertinent information:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

2.
DOCTRINAL SURVEY: Please answer briefly.
1. Who is Jesus Christ, according to your understanding? Why did He die on the cross? What is the
significance of His resurrection?
2. How does a person become a Christian?
3. What is the purpose of the Bible in your life? Do you consider it your final authority for how you make
decisions? How would you rate your Bible knowledge? (strong; moderate; minimal?)
BIOGRAPHICAL INFORMATION: Please answer briefly, attach another sheet if needed.
1. Tell how and when you came to know Christ. What is your current relationship with Him?
2. What are your reasons for wanting to be an OCEC Summer Ministries Leadership Team Assistant?
3. How would you describe your personality? What are your strengths?
4. What are your hobbies?

3.
5. With what OCEC ministries have you been involved? Include a) length of your commitment; b) duties/
responsibilities.
6. Are there other experiences/ministries with which have you been involved that have prepared you for
involvement with the Summer Ministries Leadership Team? If so, what are they?
CRIMINAL BACKGROUND CHECK: (Note: If any of the questions below are answered “YES,” please provide
a complete explanation, attaching additional sheets as necessary.)
A. Have you EVER been convicted of a sex-related crime? [ ] Yes [ ] No
If YES, was the conviction in Oregon or another state? (Please specify if another state) State: ____________
If YES, did the crime involve force or minors? [ ] Yes [ ] No
B. Have you EVER been convicted of a crime involving violence or threat of violence? [ ] Yes [ ] No
If YES, was the conviction in Oregon or another state? (Please specify if another state) State: ____________
C. Have you EVER been convicted of a crime involving criminal activity in drugs or alcoholic beverages,
including providing alcohol or drugs to a minor and/or driving while under the influence of alcohol
or drugs? [ ] Yes [ ] No
If YES, was the conviction in Oregon or another state? (Please specify if another state) State: ____________
D. Have you EVER been convicted of any other crime except minor traffic violation?
(includes Traffic Crimes) [ ] Yes [ ] No
E. Have you been arrested within the last three years for a crime for which there has not yet been
an acquittal or dismissal? [ ] Yes [ ] No
F. Have you been convicted of any traffic violations in the past three years? [ ] Yes [ ] No
PERSONAL REFERENCES (Examples: Sunday School Teachers, Pastors, Bible Study Leaders.
Please list people (preferably from OCEC) who can tell us about your character. No relatives, please!)
Name: ______________________________ Relationship: _____________________ Phone: _____________
Address: __________________________________________________________________________________
Street City State Zip
Name: ______________________________ Relationship: _____________________ Phone: _____________
Address: __________________________________________________________________________________
Street City State Zip

4.
MY PERSONAL COMMITMENT:
I am committed to standards of faithfulness to God and purity of lifestyle. Therefore:
I will refrain from the use of illegal drugs. Yes No If no, please explain:
I will refrain from drinking alcohol. Yes No If no, please explain:
I will remain sexually pure. Yes No If no, please explain:
I will seek to present a Christian witness in every aspect of my life. Therefore, I give permission to the Team
Director (Raelene Gilmore) and Pastor of Children (Sue Burson) to check out my MySpace or Facebook
account. I agree to accept them as a “friend” so they have access to my MySpace/Facebook accounts.**
Yes No If no, please explain:
My “MySpace” screen name: _________________________________________
My “Facebook” screen name: _________________________________________
(**We do not endorse the practice of using MySpace or Facebook accounts other than to represent a life dedicated to Christ.
However, we wish to view how you are representing yourself in public and therefore will check your page on a regular basis.)
CHURCH SERVICE:
OCEC desires that you continue to be involved in the church following the activities of the Summer Ministries
Leadership Team. There are a number of ways you can be involved, such as Children/Youth Worker,
Sunday School leader, S.W.A.T. Leader, KLUB JESUS, etc. In what areas of ministry do you anticipate being
involved in the future?
_______________________________________________________________________________________
_______________________________________________________________________________________
TEAM UNIFORM:
Team Assistants will be required to wear a Summer Ministries Leadership Team T-shirt to all team events.
One T-shirt will be provided. Additional T-shirt(s) may be purchased for $7 each. (Extra T-shirts may help ensure
daily presentability and can lighten your laundry load.)
T-shirt Size: ________________ I would like to purchase ______ additional T-shirt(s) for $7 each.
SIGNATURES:
I hereby certify that all the above information and statements are correct.
Signature of Applicant: _________________________________________ Date: ____________________
I hereby give approval for my son/daughter to become an OCEC Summer Ministries Leadership Team
Assistant. I understand that a calendar of events/times will be provided and I will make sure my son/daughter
has transportation and will arrive on time for his/her responsibilities.
Signature of Parent/Guardian: ___________________________________ Date: ____________________
Applications due in the CHURCH OFFICE by MONDAY, APRIL 19, 2010.