GO Team Application - North Carolina Disaster Rebuild 2020

Application Process:

1. Read the Trip FAQ 
2. Complete Part 1 of the application (below)
3. Complete Part 2 of the application, which is a background check. If you do not have a current background check on file with Blackhawk Church, info will be emailed to you after you submit this form (typically within 2-3 business days).
4. If all of this is completed on time, the trip leader will contact you in 1-3 weeks of the application deadline regarding next steps in the application process.

Applications are due by the end of the day on Sunday, December 15th, 2019.

All information on this form will be kept confidential, with disclosure related only to trip placement (Impact staff, Trip Leaders, Medical and Legal advisers, etc.) or as required by law.

*Address Line 1
Address Line 2
*City
*State/Province/Region
*Zip/Postal Code
*Preferred method of contact:
*Date of Birth:
*Will you be 21 years old or older before the trip?:
*Gender:
*Occupation:
*Trip ID# (see FAQ sheet) :
*Your name exactly as it appears on your driver's license (or alternate form of ID):
:

Your Interest in the Trip

Team leaders will be interviewing applicants on Saturday, January 11th at Blackhawk Brader Way. Please indicate time frames that you are available on January 11th.
Below are the dates for the GO Team meetings. These team meetings are an extremely important part of the GO Team process, and we expect potential team members to make every effort to attend all meetings. Please indicate whether you can attend each meeting below.:
*Sunday, February 23rd, 2020 from 2-4pm:
*Sunday, March 15th, 2020 from 1-4pm:
If there are any obstacles that might keep you from attending these meetings or the trip, please explain:
Do you speak any languages other than English? If so, what is your fluency level? (e.g., basic words, conversational, fluent)

*Please explain your primary reasons for applying for and desiring to be a part of this GO Team trip.
*Support raising is a required aspect of going on a GO Team trip. Support raising is beneficial for team members as it teaches them the importance of relying on God and fellow believers for financial, prayer, and emotional support. Where do you anticipate the funds for this trip to come from? 
*I am willing to volunteer as a driver transporting fellow GO Team members to and from North Carolina. I understand that my eligibility to transport participants is contingent upon my completion of the Blackhawk Driving Record Check & Release Agreement and its subsequent review and acceptance by appropriate Blackhawk staff. If interested, you will be emailed a link to complete Blackhawk's Driving Record Check and Release & Agreement.

Gifts & Skills

If you have taken a spiritual gifts assessment in the past, please indicate your top three spiritual gifts.:
My spiritual gift (1):
My spiritual gift (2):
My spiritual gift (3):

Skills

(check all that apply)
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*How do you wish to serve on this team?:
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Spiritual Info

*Are you are regular attender of Blackhawk Church? :
Which site do you typically attend?:
*How long have you been attending Blackhawk Church?:
If you attend another church, indicate the name:
*Briefly describe how you came to faith in Jesus Christ and how you are growing in your relationship with Him.
:

Ministry Experience

*Where are you currently serving in the church?:
*Please describe any previous or current ministry experience that you have serving adults and/or children.
*Please describe any previous or current experience that you have working/volunteering in community service.
*Have you been on a mission trip before?:
If yes, may we contact the trip leader?:
Leader's Name & Contact Info:
If you have been on a mission trip before, where, when, and for how long was your previous the trip? What did you do? 
*Have you ever served in a disaster relief/response setting before? Please describe your experience.
:

Background Info

Information will be kept confidential, with disclosure only related to ministry services, or as required by law. We ask these questions to have a more wholistic understanding of your background, and to ensure both your safety and the safety of the team as a whole.

Health Background

Do you have any medical conditions (e.g. diabetes, lactose intolerance, asthma, history of heart attack or stroke, etc.)?:
*Please indicate, if applicable:
Do you currently have or have you had in the past any mental health issues (depression, bipolar disorder, generalized anxiety disorder, history of psychiatric treatment or hospitalization, ect.)?:
*Please indicate, if applicable:
Do you have any physical limitations or conditions that will prevent you from performing certain types of activities?:
*Please indicate, if applicable:
Do you have any dietary restrictions?
*Please indicate, if applicable:

Social Background 

Do you have a drug, alcohol and/or anger problem? Does anyone who knows you think that you have a drug, alcohol and/or anger problem?:
*Please indicate, if applicable:
Are there any past or present issues (spiritual, physical, emotional/mental, social), which would hinder your ability to work appropriately with children? :
*Please indicate, if applicable:
Have you in the past or are you currently struggling with any addictions (alcohol, drug, pornography, etc.)?:
*Please indicate, if applicable:
Have you ever been accused, charged, or convicted of a criminal offense (felony or misdemeanor) other than a parking violation? :
*Please indicate, if applicable:
:

References

References are required for consideration for this trip and to meet our Child Protection Policy standards. Please provide complete mailing addresses and email address for three references that have acquired accurate knowledge of your character and meet the following criteria: 
  • Known you for more than one year
  • At least 18 years old
  • Not related to you
  • Not your significant other (e.g., boy/girlfriend, spouse)
  • Not a Blackhawk staff member
  • If possible, have witnessed you interacting with children.
*Reference #1 Name:
*Reference #1 Relationship:
*Reference #1 Email:
*Reference #1 Address:
:
*Reference #2 Name:
*Reference #2 Relationship:
*Reference #2 Email:
*Reference #2 Address:
:
*Reference #3 Name:
*Reference #3 Relationship:
*Reference #3 Email:
*Reference #3 Address:
*Blackhawk completes background checks upon the start of service, and then every three years for continued service. In the time between background checks, I understand that I am required to self-report any misdemeanor charges/convictions, felony charges/convictions or alcohol- or drug-related citations I receive during the season I am in service to Blackhawk.
Upon submitting this form, if you do not have a current background check on file with Blackhawk Church, you will receive an email (typically within 2-3 business days) about providing background check information. YOUR APPLICATION WILL NOT BE CONSIDERED COMPLETE UNTIL YOU HAVE SUBMITTED YOUR BACKGROUND CHECK via the instructions provided through email (if applicable).

By signing below I agree that the information provided in this application is true, and I authorize the Church (Blackhawk Evangelical Free Church and/or its representative) to verify the information on this form. I authorize any organizations, institutions, churches or references listed in this application to give the church any information (including opinions) that they may have regarding my character and suitability for participation in this trip. I hereby release any individual, organization, employer, church or reference from any and all liability for any damages that may at any time result to me, my heirs, or family, on account of compliance or any attempt to comply with this authorization. Should my application be accepted I agree to adhere to all policies of Blackhawk Church.

In the interest of safety and security I, the undersigned applicant, authorize Blackhawk Evangelical Free Church to procure background information about me, prior to, and at any time during, my service to the organization. This report may include my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history/records; and the state sex offender records. I understand that I am entitled to a complete copy of any background information report of which I am the subject upon my request. Also, I understand that I may receive a written summary of my rights under the Fair Credit Reporting Act. :
*Signature: