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Ministries
Ministries
We love because He first loved us.
I John 4:19
Table of Contents
Mission and Vision Of Cultivate
Demographics
Biblical Ministry Model
Cultivation Model
Harvest
Greenhouse
The Vine
Rooted
Dig
Transitional Events
Budget
Dallas After Dark
Bridgeport Camp
Calendar
Forms
Personal Profile
5
6
7
8 - 9
10 - 11
12 - 13
14 - 15
16
17
18
19
20
21
22 - 27
28 - 30
31
5
Vision
Cultivate is a ministry reaching out to those who are lost, lonely, and
oppressed. It is a place where students in 6th to 12th grade can come and feel
welcome no matter who they are. At Cultivate we reach out to students, bring
them in, and develop them to become future leaders of their generation. A
student who is involved in Cultivate ministries will learn how to approach
trials, temptations, and still stay true to the faith at every stage of life,
learning how to combine faith and culture.
Mission
Our ministry is based on love and community. We strive to foster an
atmosphere of love and acceptance to all people. Surrounding anyone who
comes into the doors of Cultivate with the love of Christ.
God is love. Whoever lives in love lives in God, and God in them. This is how
love is made complete among us so that we will have confidence on the Day of
Judgment: In this world we are like Jesus. There is no fear in love. But
perfect love drives out fear, because fear has to do with punishment. The one
who fears is not made perfect in love.
We love because He first loved us.
I John 4:16-19
6
	 Population- 88,547
	 20 public schools from elementary school through high 	
	school
	 o	 Three middle schools
	 	 •	 Middle school population- 3,062
	 o	 One high school
	 	 •	 High school population- 5,663
	 Average income- $109,846
	 Top three ethnicities
	 o	 White- 65%
	 o	 Asian- 13%
	 o	 Hispanic- 11%
	 Top three religious affiliations
	 o	 Catholic- 34%
	 o	 Southern Baptist Convention- 30%
	 o	 United Methodist- 11%
Community
Breakdown of
Allen, TX
Average Sunday Morning Attendance
•	 675 People
Average Youth Attendance
•	 80-90 Students
Services Offered
•	 Three on Sunday Morning
First United
Methodist Church
of Allen (FUMCA)
7
Ministry
Skeleton This Ministry model is based on Biblical
principles that were lived by Jesus Christ
in His Ministry. Looking at Jesus’ life and
the life of the disciples we can see this
model being lived out by seeing the way
they interacted other people and
themselves. I believe this is the most
effective ministry model because it is
Biblical. This model is not only meant for
bigger sized churches it can also be used
for small ministries.
8
Mass
•  Connecting with others who normally do not
come to church.
•  Meeting the People where they are at
	 o  Jesus was in proximity with others 	 	
	 who did not know Him
•  These are events intended to reach out to
those who normally do not come to church
•  How did Jesus do this? The feeding of the
5,000 (Matt. 14:14)
Crowd
•  This is meant for the people who come on a
regular basis
•  There has to be a sense of unity
between the students
•  Worship and a teaching of the Word happens
•	 Good place for 52/52 to take place
	 o  52/52 means consistency, it happens 		
just about every week of the year
	 o It is important for students to have 		
consistency
•  Unity for the disciples happens in the 	 	
Upper Room (Acts: 2)
Discipleship
•  An atmosphere of accountability is fostered in this part of the ministry
•  This looks like small groups/Discipleship groups/Bible Studies
•  In these groups there is development from different adult leaders who invest into students
•  In Jesus’ ministry He calls the twelve disciples to be living together in a small group
•  “Whoever wants to be a disciple, must deny themselves and take up their cross”
•  Matthew 16:24
9
Leader/Laborer
•  This is for students who have a desire to invest back into the ministry
•  Anybody willing to serve and finding a place to serve
•  Students should feel ownership of where they serve
•  This can be a youth leadership team
•  Peter, James, and John were the people in Jesus’ ministry who fit this role (The Inner Three)
•  An example of where this takes in Jesus’ ministry is when the inner three go up to the mountain with Jesus
and experience the transfiguration. (Matt 17:1-2)
Mentor
•  One-on-one investment- Between student and pastor
•  People have to be called to each other
•  Pouring into the life of another person, spending almost everyday with that person
•  Used when students feel like they have a calling to be in ministry
•  This was the relationship between Jesus and Peter. (Matthew 14:25-31)
Mass - The Harvest
The Harvest is a time when farms gather crops. The Harvest
when in reference to the ministry of Cultivate is an opportunity for
the students who already come to cultivate on a regular basis to
invite/gather students who are not apart of Cultivate. When these
events take place there has to be promotion that reaches out to
students who would normally not come to Cultivate.
10
11
E
v
e
n
t
s
Open Field
o	 Use the field behind the church to play ultimate Frisbee,
soccer, or football. Open it to the community and have people
who are from the community and from the church connect.
o	 Cost: Free!
Lock-in
o	 Students arrive at 8 PM and they go until 9 AM. This will be a
time when students from the church can invite their friends to join
them for a night filled with fun, games, food, and fellowship.
o	 Cost: $ 5
Dallas After Dark (High School)
o	 Students have no idea where they are going, they hop in
vans and then we take them to three different fun filled places,
crashing at the church.
o	 Cost: $ 50
Dallas Day Away (Middle School)
o	 Just like Dallas After Dark but for middle school students.
Student have no idea where they are going, they hop in the vans
and are taken to some exciting places catered to them.
o	 Cost: $ 35
Crowd - Greenhouse
A greenhouse is a place where plants are protected from harsh
conditions. At Cultivate Greenhouse is the consistent meeting
time for students, where they can feel safe and be loved. This is
for students who want to commit to coming to Cultivate but not
wanting a huge time commitment. What a Greenhouse event
looks like is a time fellowship (dinner), games, and then a stu-
dent-led worship service with a teaching of the Word.
12
13
E
v
e
n
t
s
Unity Event
o	 The three UMC churches in Allen, TX come together for fel-
lowship, food, and community. During this time there will be activi-
ties as well as worship and the Word.
o	 Cost: $ 5
UMYF
o	 Every Sunday night. Worship and the Word plus dinner and
activities.
Sunday Morning Bible Study
o	 Each grade will have different topics that are talked about.
Whether that is going through a book of the Bible or a specific
kind of curriculum.
Discipleship - The Vine
A vine is a kind of stem that produces grapes. On this stem the
grapes are produced in bunches. When students attend Vine
events they will be apart of the stems of Cultivate. Just like a
grapes on a vine students will be placed in small groups accord-
ing to according to their age/what they are interested in. These
small groups will consist of about eight to twelve students who are
lead by adult volunteers who are passionate about investing into
students.
14
15
E
v
e
n
t
s
Focus Groups
o	 Wednesday night is Bible study night at the church. Adults
who are in Bible studies go to the church on Wednesday nights,
this allows for adults to bring their students to get plugged into a
focus group. We will have different Bible studies on different
topics
In Home Bible Studies
o	 For Juniors and Seniors
o	 Have a Bible study at a house. A time for fellowship and in
depth Bible study on deep life issues, before students graduate
high school. Led by someone who has extensive
theological/Biblical training.
Leader/Laborer - Rooted
When we see large trees we are often astounded at the beauty
and strength of the tree but many times we forget its roots hold up
the tree. In Cultivate ministries Rooted is a place for students to
be able to grow their roots into the ministry. It is for students to be
apart of the roots of Cultivate. They are able to help make deci-
sions on what the ministry looks like.
Youth Leadership Team
A group of Students will meet once a month to talk about the
happenings of Cultivate.
16
17
Mentor - Dig
In the farming world when people dig it is to plant seeds.
Mentorship is a serious calling upon the lives of two people. At
Cultivate when a student senses a calling into the ministry there
needs to be a person who can mentor them to pursue their
calling. Even if a student does not immediately sense a calling
into the ministry, but an adult leader sees potential in a student
there needs to be people who are available to who are their to
plant the seeds and develop the student.
18
Transitional Events
Transitional evens are for students to become more invested in
the ministry. These events could be anything from a fun filled
week at camp to conferences that stretch the faith of students
and making them rethink the way the are living. In order for these
events to be effective there needs to be the next area where the
students can be involved in. For example, if we advertise to our
mass students about camp, and while they are camp they
experience a deepening of their faith, there has to be the
consistency of crowd events for them to attend once camp is
over. As students go deeper in the ministry model more ministry
flows out from them.
E
v
e
n
t
s
Encounter Lock-in
o	 A time of intentional worship and the Word. There will be activities
and food, but the emphasis of this Lock-in will be for students to engage in
a more meaningful worship and dive deep into the Word.
Camp
o	 A week long time of fun, fellowship, and growth. When students
come to camp this is a perfect opportunity for them to take the next step in
the ministry. Some students will go the next step others will not yet make
the jump, either way there must be the next step for students to involved
in after camp.
19
Annual Budget
Supplies/resources 	 	 	 $    120
Food					 $ 200
Curriculum 				 $ 200
Outreach events			 $ 720
Trips/retreats		 	 	 $ 2,100
Service events local 		 $ 100
Summer Mission Trip 		 $ 1,500
Transportation 			 $ 500
Parent Ministry 	 	 	 $    200
Volunteer				 $ 200
Advertising 				 $ 200
	 	 	 	 	 $ 6,000
19
20
Dallas After Dark
(All-nighter UMC Style)
Event Budget
Planning on 50 Students
(Zero Based Budget)
Whirly Ball	 	 	   $    300
Speed Zone			 $ 1,250
Broomball			 $ 500
Pizza/Food	 	 	   $    100
Transportation 		 $ 200
					
	 	 	 	 	   $ 2,350
$50 per Student
20
21
Bridgeport Camp
(Supplemental Budget)
Calculating 20 students for the entire
week, everything
included. Transportation on your own.
Scholarships are available for students
- $ 700 (Based on fundraising)
$ 325 per Student
Adults do not have to pay to go.
1 adult per 5 students. Compensation
of about $ 100 per adult as a thank you
$ 400 Compensation cost
21
22
June
July
The Vine
Every Wednesday night
Rooted
Every 3rd Thursday
Bridgeport Camp
23
August
September
Harvest
Once a month
Greenhouse
Every Sunday
DALLASAFTERDARK
August 8th at 7PM
(Harvest Event for August)
24
October
November
The Vine
Every Wednesday night
Rooted
Every 3rd Thursday
25
December
January
Harvest
Once a month
Greenhouse
Every Sunday
26
February
March
The Vine
Every Wednesday night
Rooted
Every 3rd Thursday
27
April
May
Harvest
Once a month
Greenhouse
Every Sunday
28
[Church Name]
[Contact Name and Phone #]
Event
Medical Release & Permission Form
Page 1 of 2
Effective dates: _____________ to _____________
Please print in ink
Name: ___________________________________________________ Age ________ Birthday ______________
LAST FIRST MIDDLE
Year in school  Male  Female Email
Address City State Zip
Phone Pager / cell
Medical insurance company Policy #
Mother’s name Phone: Home Work
Father’s name Phone: Home Work
Emergency contact Phone: Home Work
Physician ________________________________________Office phone __________________________________
Dentist __________________________________________Office phone __________________________________
If necessary, describe in detail the nature and severity of any physical and/or psychological ailment, illness, propensity,
weakness, limitation, handicap, disability, or condition to which your child is subject and of which the staff should be
aware, and what, if any action of protection is required on account thereof. Submit this notification in writing and attach
it to this form. Include names of medications and dosages that must be taken.
Check the following areas of concern for this student. If necessary, add another page with details:
1. For your child’s safety and our knowledge, is your student a
 good swimmer  fair swimmer  non-swimmer
2. Does your child have allergies to
 pollens  medications  food  insect bites
3. Does your child suffer from, or has ever experienced, or is being treated currently for any of the following:
 asthma  epilepsy / seizure disorder  heart trouble  diabetes
 frequently upset stomach  physical handicap
4. Date of last tetanus shot:
5. Does your child wear  glasses  contact lenses
6. Please list and explain any major illnesses the child experienced during the last year:
Additional comments:
Should this child’s activities be restricted for any reason? Please explain:
Medical History
29
Page 1 for student to fill out, pages 2 & 3 for office use only.
[Church Name]
[Contact Name and Phone #]
Student Data
Student Profile
Confidential Page 1 of 3
Today's date
Student name Phone
 Male  Female E-mail address
Address City State Zip
Birthday School Graduation year
Father's name Stepfather's name
Mother's name Stepmother's name
With whom do you live?
Parent’s phone Parent's email address
Do your parents attend this church?  Yes  No
Do they attend an adult education class?  Yes  No If yes, which one(s)?
Brothers/sisters
Name Age/grade
Name Age/grade
Name Age/grade
Name Age/grade
Sports  Basketball  Baseball  Football  Soccer  Volleyball  Hockey
 Swimming  Broomball  Tennis  Golf  Gymnastics  Wrestling
 Water-skiing  Water Polo  Track/Cross Country  Water polo  Lacrosse
 Skiing/snowboarding  Other
Music  Likes to sing!  Instruments
Hobbies  Drama  Computer  Reading  Other
Personal Information
Family information
Interests check all that apply
30
[Church Name]
[Contact Name and Phone #}
Volunteer/Youth Ministry
Staff Application 1
Confidential Page 1 of 3
Ministry code ____________
This application is to be completed by all applicants for any volunteer or compensated position involving
the supervision or custody of minors. This is not an employment application. Persons seeking a position in
the church as paid employees will be required to complete an employment application in addition to this
screening form. Thank you for helping our church provide a safe and secure environment for children and
youth who participate in our programs and use our facilities.
Date
Name Spouse's name
Address City State Zip
Home phone Work phone
Date of birth Social Security #
Do you regularly attend our weekend services?  Yes  No If yes, since when?
Do you regularly attend a small group?  Yes  No If yes, since when?
In what church ministries are you presently involved?
In what areas of church ministry are you currently serving?
Have you personally accepted Jesus Christ as your Lord and Savior, and are you committed to having the
character of Jesus live through you? Yes No
Tell us about your spiritual journey to date
Tell us why you have chosen to work with youth at our church.
General information
Background information
31
My name is David Magallanes. I
graduated from Indiana Wesleyan
University in the spring of 2015 with a
Bachelor of Science degree in Youth
Ministry and Christian Worship. I have
a passion reaching out to youth who
are lost, lonely and have nowhere to
run to. I want my life to reflect the
love of Christ to others through my
actions and words. I love watching
movies, playing guitar, and being in
community with the people around
me. If you want the key to my heart
bake me any kind of sweet dessert.
Cultivate Ministry (Programming Model)

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Cultivate Ministry (Programming Model)

  • 2.
  • 3. Ministries We love because He first loved us. I John 4:19
  • 4. Table of Contents Mission and Vision Of Cultivate Demographics Biblical Ministry Model Cultivation Model Harvest Greenhouse The Vine Rooted Dig Transitional Events Budget Dallas After Dark Bridgeport Camp Calendar Forms Personal Profile 5 6 7 8 - 9 10 - 11 12 - 13 14 - 15 16 17 18 19 20 21 22 - 27 28 - 30 31
  • 5. 5 Vision Cultivate is a ministry reaching out to those who are lost, lonely, and oppressed. It is a place where students in 6th to 12th grade can come and feel welcome no matter who they are. At Cultivate we reach out to students, bring them in, and develop them to become future leaders of their generation. A student who is involved in Cultivate ministries will learn how to approach trials, temptations, and still stay true to the faith at every stage of life, learning how to combine faith and culture. Mission Our ministry is based on love and community. We strive to foster an atmosphere of love and acceptance to all people. Surrounding anyone who comes into the doors of Cultivate with the love of Christ. God is love. Whoever lives in love lives in God, and God in them. This is how love is made complete among us so that we will have confidence on the Day of Judgment: In this world we are like Jesus. There is no fear in love. But perfect love drives out fear, because fear has to do with punishment. The one who fears is not made perfect in love. We love because He first loved us. I John 4:16-19
  • 6. 6 Population- 88,547 20 public schools from elementary school through high school o Three middle schools • Middle school population- 3,062 o One high school • High school population- 5,663 Average income- $109,846 Top three ethnicities o White- 65% o Asian- 13% o Hispanic- 11% Top three religious affiliations o Catholic- 34% o Southern Baptist Convention- 30% o United Methodist- 11% Community Breakdown of Allen, TX Average Sunday Morning Attendance • 675 People Average Youth Attendance • 80-90 Students Services Offered • Three on Sunday Morning First United Methodist Church of Allen (FUMCA)
  • 7. 7 Ministry Skeleton This Ministry model is based on Biblical principles that were lived by Jesus Christ in His Ministry. Looking at Jesus’ life and the life of the disciples we can see this model being lived out by seeing the way they interacted other people and themselves. I believe this is the most effective ministry model because it is Biblical. This model is not only meant for bigger sized churches it can also be used for small ministries.
  • 8. 8 Mass • Connecting with others who normally do not come to church. • Meeting the People where they are at o Jesus was in proximity with others who did not know Him • These are events intended to reach out to those who normally do not come to church • How did Jesus do this? The feeding of the 5,000 (Matt. 14:14) Crowd • This is meant for the people who come on a regular basis • There has to be a sense of unity between the students • Worship and a teaching of the Word happens • Good place for 52/52 to take place o 52/52 means consistency, it happens just about every week of the year o It is important for students to have consistency • Unity for the disciples happens in the Upper Room (Acts: 2) Discipleship • An atmosphere of accountability is fostered in this part of the ministry • This looks like small groups/Discipleship groups/Bible Studies • In these groups there is development from different adult leaders who invest into students • In Jesus’ ministry He calls the twelve disciples to be living together in a small group • “Whoever wants to be a disciple, must deny themselves and take up their cross” • Matthew 16:24
  • 9. 9 Leader/Laborer • This is for students who have a desire to invest back into the ministry • Anybody willing to serve and finding a place to serve • Students should feel ownership of where they serve • This can be a youth leadership team • Peter, James, and John were the people in Jesus’ ministry who fit this role (The Inner Three) • An example of where this takes in Jesus’ ministry is when the inner three go up to the mountain with Jesus and experience the transfiguration. (Matt 17:1-2) Mentor • One-on-one investment- Between student and pastor • People have to be called to each other • Pouring into the life of another person, spending almost everyday with that person • Used when students feel like they have a calling to be in ministry • This was the relationship between Jesus and Peter. (Matthew 14:25-31)
  • 10. Mass - The Harvest The Harvest is a time when farms gather crops. The Harvest when in reference to the ministry of Cultivate is an opportunity for the students who already come to cultivate on a regular basis to invite/gather students who are not apart of Cultivate. When these events take place there has to be promotion that reaches out to students who would normally not come to Cultivate. 10
  • 11. 11 E v e n t s Open Field o Use the field behind the church to play ultimate Frisbee, soccer, or football. Open it to the community and have people who are from the community and from the church connect. o Cost: Free! Lock-in o Students arrive at 8 PM and they go until 9 AM. This will be a time when students from the church can invite their friends to join them for a night filled with fun, games, food, and fellowship. o Cost: $ 5 Dallas After Dark (High School) o Students have no idea where they are going, they hop in vans and then we take them to three different fun filled places, crashing at the church. o Cost: $ 50 Dallas Day Away (Middle School) o Just like Dallas After Dark but for middle school students. Student have no idea where they are going, they hop in the vans and are taken to some exciting places catered to them. o Cost: $ 35
  • 12. Crowd - Greenhouse A greenhouse is a place where plants are protected from harsh conditions. At Cultivate Greenhouse is the consistent meeting time for students, where they can feel safe and be loved. This is for students who want to commit to coming to Cultivate but not wanting a huge time commitment. What a Greenhouse event looks like is a time fellowship (dinner), games, and then a stu- dent-led worship service with a teaching of the Word. 12
  • 13. 13 E v e n t s Unity Event o The three UMC churches in Allen, TX come together for fel- lowship, food, and community. During this time there will be activi- ties as well as worship and the Word. o Cost: $ 5 UMYF o Every Sunday night. Worship and the Word plus dinner and activities. Sunday Morning Bible Study o Each grade will have different topics that are talked about. Whether that is going through a book of the Bible or a specific kind of curriculum.
  • 14. Discipleship - The Vine A vine is a kind of stem that produces grapes. On this stem the grapes are produced in bunches. When students attend Vine events they will be apart of the stems of Cultivate. Just like a grapes on a vine students will be placed in small groups accord- ing to according to their age/what they are interested in. These small groups will consist of about eight to twelve students who are lead by adult volunteers who are passionate about investing into students. 14
  • 15. 15 E v e n t s Focus Groups o Wednesday night is Bible study night at the church. Adults who are in Bible studies go to the church on Wednesday nights, this allows for adults to bring their students to get plugged into a focus group. We will have different Bible studies on different topics In Home Bible Studies o For Juniors and Seniors o Have a Bible study at a house. A time for fellowship and in depth Bible study on deep life issues, before students graduate high school. Led by someone who has extensive theological/Biblical training.
  • 16. Leader/Laborer - Rooted When we see large trees we are often astounded at the beauty and strength of the tree but many times we forget its roots hold up the tree. In Cultivate ministries Rooted is a place for students to be able to grow their roots into the ministry. It is for students to be apart of the roots of Cultivate. They are able to help make deci- sions on what the ministry looks like. Youth Leadership Team A group of Students will meet once a month to talk about the happenings of Cultivate. 16
  • 17. 17 Mentor - Dig In the farming world when people dig it is to plant seeds. Mentorship is a serious calling upon the lives of two people. At Cultivate when a student senses a calling into the ministry there needs to be a person who can mentor them to pursue their calling. Even if a student does not immediately sense a calling into the ministry, but an adult leader sees potential in a student there needs to be people who are available to who are their to plant the seeds and develop the student.
  • 18. 18 Transitional Events Transitional evens are for students to become more invested in the ministry. These events could be anything from a fun filled week at camp to conferences that stretch the faith of students and making them rethink the way the are living. In order for these events to be effective there needs to be the next area where the students can be involved in. For example, if we advertise to our mass students about camp, and while they are camp they experience a deepening of their faith, there has to be the consistency of crowd events for them to attend once camp is over. As students go deeper in the ministry model more ministry flows out from them. E v e n t s Encounter Lock-in o A time of intentional worship and the Word. There will be activities and food, but the emphasis of this Lock-in will be for students to engage in a more meaningful worship and dive deep into the Word. Camp o A week long time of fun, fellowship, and growth. When students come to camp this is a perfect opportunity for them to take the next step in the ministry. Some students will go the next step others will not yet make the jump, either way there must be the next step for students to involved in after camp.
  • 19. 19 Annual Budget Supplies/resources $ 120 Food $ 200 Curriculum $ 200 Outreach events $ 720 Trips/retreats $ 2,100 Service events local $ 100 Summer Mission Trip $ 1,500 Transportation $ 500 Parent Ministry $ 200 Volunteer $ 200 Advertising $ 200 $ 6,000 19
  • 20. 20 Dallas After Dark (All-nighter UMC Style) Event Budget Planning on 50 Students (Zero Based Budget) Whirly Ball $ 300 Speed Zone $ 1,250 Broomball $ 500 Pizza/Food $ 100 Transportation $ 200 $ 2,350 $50 per Student 20
  • 21. 21 Bridgeport Camp (Supplemental Budget) Calculating 20 students for the entire week, everything included. Transportation on your own. Scholarships are available for students - $ 700 (Based on fundraising) $ 325 per Student Adults do not have to pay to go. 1 adult per 5 students. Compensation of about $ 100 per adult as a thank you $ 400 Compensation cost 21
  • 22. 22 June July The Vine Every Wednesday night Rooted Every 3rd Thursday Bridgeport Camp
  • 23. 23 August September Harvest Once a month Greenhouse Every Sunday DALLASAFTERDARK August 8th at 7PM (Harvest Event for August)
  • 24. 24 October November The Vine Every Wednesday night Rooted Every 3rd Thursday
  • 26. 26 February March The Vine Every Wednesday night Rooted Every 3rd Thursday
  • 28. 28 [Church Name] [Contact Name and Phone #] Event Medical Release & Permission Form Page 1 of 2 Effective dates: _____________ to _____________ Please print in ink Name: ___________________________________________________ Age ________ Birthday ______________ LAST FIRST MIDDLE Year in school  Male  Female Email Address City State Zip Phone Pager / cell Medical insurance company Policy # Mother’s name Phone: Home Work Father’s name Phone: Home Work Emergency contact Phone: Home Work Physician ________________________________________Office phone __________________________________ Dentist __________________________________________Office phone __________________________________ If necessary, describe in detail the nature and severity of any physical and/or psychological ailment, illness, propensity, weakness, limitation, handicap, disability, or condition to which your child is subject and of which the staff should be aware, and what, if any action of protection is required on account thereof. Submit this notification in writing and attach it to this form. Include names of medications and dosages that must be taken. Check the following areas of concern for this student. If necessary, add another page with details: 1. For your child’s safety and our knowledge, is your student a  good swimmer  fair swimmer  non-swimmer 2. Does your child have allergies to  pollens  medications  food  insect bites 3. Does your child suffer from, or has ever experienced, or is being treated currently for any of the following:  asthma  epilepsy / seizure disorder  heart trouble  diabetes  frequently upset stomach  physical handicap 4. Date of last tetanus shot: 5. Does your child wear  glasses  contact lenses 6. Please list and explain any major illnesses the child experienced during the last year: Additional comments: Should this child’s activities be restricted for any reason? Please explain: Medical History
  • 29. 29 Page 1 for student to fill out, pages 2 & 3 for office use only. [Church Name] [Contact Name and Phone #] Student Data Student Profile Confidential Page 1 of 3 Today's date Student name Phone  Male  Female E-mail address Address City State Zip Birthday School Graduation year Father's name Stepfather's name Mother's name Stepmother's name With whom do you live? Parent’s phone Parent's email address Do your parents attend this church?  Yes  No Do they attend an adult education class?  Yes  No If yes, which one(s)? Brothers/sisters Name Age/grade Name Age/grade Name Age/grade Name Age/grade Sports  Basketball  Baseball  Football  Soccer  Volleyball  Hockey  Swimming  Broomball  Tennis  Golf  Gymnastics  Wrestling  Water-skiing  Water Polo  Track/Cross Country  Water polo  Lacrosse  Skiing/snowboarding  Other Music  Likes to sing!  Instruments Hobbies  Drama  Computer  Reading  Other Personal Information Family information Interests check all that apply
  • 30. 30 [Church Name] [Contact Name and Phone #} Volunteer/Youth Ministry Staff Application 1 Confidential Page 1 of 3 Ministry code ____________ This application is to be completed by all applicants for any volunteer or compensated position involving the supervision or custody of minors. This is not an employment application. Persons seeking a position in the church as paid employees will be required to complete an employment application in addition to this screening form. Thank you for helping our church provide a safe and secure environment for children and youth who participate in our programs and use our facilities. Date Name Spouse's name Address City State Zip Home phone Work phone Date of birth Social Security # Do you regularly attend our weekend services?  Yes  No If yes, since when? Do you regularly attend a small group?  Yes  No If yes, since when? In what church ministries are you presently involved? In what areas of church ministry are you currently serving? Have you personally accepted Jesus Christ as your Lord and Savior, and are you committed to having the character of Jesus live through you? Yes No Tell us about your spiritual journey to date Tell us why you have chosen to work with youth at our church. General information Background information
  • 31. 31 My name is David Magallanes. I graduated from Indiana Wesleyan University in the spring of 2015 with a Bachelor of Science degree in Youth Ministry and Christian Worship. I have a passion reaching out to youth who are lost, lonely and have nowhere to run to. I want my life to reflect the love of Christ to others through my actions and words. I love watching movies, playing guitar, and being in community with the people around me. If you want the key to my heart bake me any kind of sweet dessert.