SRT Volunteer Application

Thanks for your interest in serving with our Safety Response Team! We love your desire to keep Mosaic safe and healthy on Sundays. Go ahead and complete the application below and someone will follow up with you on next steps.

All applicants must have been attending Mosaic for at least 3 months in order to serve on this team.

Form Entry

First Name

Last Name

Mobile Phone

Birthdate

/ /

Gender

Male Female

Address

Involvement at Mosaic

How long have you attended Mosaic?

Have you participated in a Mosaic Group within the last 12 months?

Are you currently on a Mosaic Serving team?

Have you served in any leadership roles at Mosaic?

Have you been consciously baptized, by water emersion?

Background

Are you active military?

What security and/or medical background do you have to help you be qualified to serve on this team?

Have you ever served on a security team at another church before?

Have you ever been arrested or convicted of a crime?

Have you ever been accused, charged, or alleged to have committed any act of neglecting, abusing, molesting, or battering a child or adult?

Is there any circumstance in your life that would make it inappropriate for you to serve with minors or that would compromise the integrity of Mosaic that we should be aware of?

Concealed Carry Permit

Do you currently hold a concealed carry permit?

Reference #1

Note: At least one reference must be someone that regularly attends Mosaic.

Reference #1: First and Last Name

Reference #1: Email Address

Reference #1: Phone Number

Reference #1: Relationship to You

Reference #1: Length of Time Known

Reference #2

Note: At least one reference must be someone that regularly attends Mosaic.

Reference #2: First and Last Name

Reference #2: Email Address

Reference #2: Phone Number

Reference #2: Relationship to You

Reference #2: Length of Time Known

Officers with Marked Vehicles

Do you drive a marked vehicle?

Team Expectations

INTEGRITY: Your actions do not compromise your ability to meet the requirements of and serve on this team, including a background check run every three years.

I understand and agree to the above statement.

ACCOUNTABILITY: Follow-through is paramount to ensuring our team is staffed, communication is clear and everyone has what they need to ensure a safe and secure environment. As a member of the team, you commit to honoring your fellow team members and leaders by your accountability to your serving schedule, communicating with others, and doing what's necessary to protect everyone.

I understand and agree to the above statement.

EMBRACING CHANGE: Things change quickly and our team will need to embrace, champion and drive change with lots of different volunteers and guests. Things may move quickly and adjustments may need to happen in case of emergency, necessary weekend serving team coverage and staffing special events.

I understand and agree to the above statement.

HUMILITY AND HONOR: While we are a SRT member, above all we are serving the CHURCH and its people. When things are going well and you’re doing your job right, they have no idea who you are or what you’re doing. This is not an easily recognizable position that gets frequent recognition. There is a unique blend of ensuring that any safety-related situation is handled with the appropriate level of action, but also doing so in the least confrontational/abrasive way possible. The goal is to simultaneously protect our church from potentially harmful situations, while still upholding our values and setting a Christ-like example, as we are ALL broken, messy people.

I understand and agree to the above statement.

Applicant Information

SSN

Driver's License Number

Driver's License Issuing State

Applicant Authorization

In the interest of safety and security I, the undersigned applicant (also known as “consumer”), authorize Mosaic Christian Church through its independent contractor, Protect my Ministry, to procure background information (also known as a “consumer report and/or investigative consumer report”) 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 and agree to the above statement.

I understand that I am entitled to a complete copy of any background information report of which I am the subject upon my request to Mosaic Christian Church if such is made within a reasonable time from the date it was produced. I also understand that I may receive a written summary of my rights under the Fair Credit Reporting Act.

I understand and agree to the above statement.

Applicant Signature

By typing your name below, you are allowing Mosaic to complete this background check report on you.

Date Signed

Submit