ADULT YOUTH LEADER APPLICATION
Covenant Presbyterian Church
32 Southgate Ct., Suite 101
Harrisonburg, VA 22801
(540) 433-3051
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  • In the interest of time, please keep all answers brief.

    BACKGROUND INFORMATION
  • MINISTRY AND LEADERSHIP EXPERIENCE

  • PERSONAL TESTIMONY

  • LIFESTYLE

  • CHILD PROTECTION

    Covenant Presbyterian Church requires anyone who works with children (17 years of age and younger) to be Child Protection Approved. If you are unsure if you are Child Protection Approved, please contact Rebecca Griffin.

    If you are NOT Child Protection Approved please complete the following:

    All applicants: Please provide two, NON-RELATED references who are 18 years or older, and can attest to your character. After submitting this form please return to the church website and go to the Children's Ministries Child Protection page. Under Youth Ministries click on "Personal References" and complete the form. Or click the link below. It will open in a new tab.

    Age 18 or older: After submitting this form please return to the church website and go to the Children's Ministries Child Protection page. Under Youth Ministries click on "Background Check" and "Disclosure Statement" and complete the forms. Or click the links below. The forms will open in a new tab.

  • SIGNATURE

    All information on this application is confidential and will be used solely by the CPC staff for evaluation purposes only.

    I have read and agree to all Child Protection Policies (Child Protection Policies are on the Children's Ministry/Child Protection webpage). I am giving my authorization to Covenant Presbyterian Church to verify the information on this form and to contact my references.

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