Get Connected Form We are so excited that you are interested in making Harvest home! This form is designed to help you get connected into two vital ways here at Harvest Niagara — your walk with Christ in a small group and your work for Christ in serving. All information shared remains confidential.Husbands and wives, please complete separate formsI would like to be a part of a small group*YesNoI would like to volunteer to serve*YesNoAre you already in a small group?*YesNo Personal InformationFull Name* First Last Date of Birth* DD MM YYYY Email Home PhoneCell PhoneAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country OccupationI’ve been attending Harvest Niagara for:Less than 1 month1-3 months3-6 months6-12 monthsover 1 yearI heard about Harvest through: Family/Friend I live in the area Website Walk in the Word Live in the Light Other Other (Please specify)I have attended Discover Harvest*YesNoI have attended Harvest Essentials*YesNoI have read the Harvest Bible Chapel doctrinal statement*YesNo Spiritual InformationGive a brief testimony of when and how you became a follower of Jesus ChristWhat are you doing to grow spiritually? How have you been growing recently?Explain the gospel in your own words. Give scripture to support your answer. Walk With Christ (Small Group):Why do you want to be in a small group?Have you been in a small group before? If yes, briefly describe your experience.How would you define commitment?What is your church background?I have read the Small Group CovenantYesNoTo help us place you in a group that is best suited, please let us know your status:SingleMarriedDivorcedWidowedMy preferred location for small group:GrimsbySt. CatharinesNOTLNiagara FallsFenwick/FonthillWelland/Port ColbourneCheck available evenings (approx. 7:00 – 9:30 PM): Monday Tuesday Wednesday Thursday Work For Christ (Serving Opportunities):Please pick the one area of ministry that you are most passionate about, but please note that your preference does not guarantee you will be placed in a particular role. Unless otherwise noted, all of our ministry teams serve one full Sunday for both services, and then take three Sundays off.Describe your spiritual gifts and previous experience in ministry.Hospitality MinistryHelping prepare and serve light meals to the teams of volunteers serving on Sunday mornings. I am interested in serving in Hospitality Ministry Welcome MinistryLovingly welcoming people to church each week. Roles include parking attendants, greeters, ushers. I am interested in serving in Welcome Ministry Production MinistryIncludes A/V teams (responsible for sound, video, and lighting) and Set-Up/Tear-Down teams (responsible for the transport and care of equipment and signage). I am interested in serving in the Production Ministry Worship MinistryJoyfully lead songs of praise with voice or instrument in order to allow the congregation to enter into worship to the Lord with their hearts and minds. I am interested in serving in Worship Ministry Prayer MinistryBe part of a team that prays during our Sunday morning worship services. I am interested in serving in Prayer Ministry Student MinistryMentor youth (Grades 6-12) on Thursday evenings through Bible teaching, worship, small groups, prayer, games and events. I am interested in serving in Student Ministry Special Needs Buddy MinistryBecome paired with a child with special needs so that they might grow in Christ and in fellowship with others through the existing kids ministry of our church. [Ages 16+] I am interested in serving in Special Needs Buddy Ministry Harvest KidsHarvest Kids is much more than just childcare on Sunday mornings; it is a vital, life-transforming ministry of our church! Volunteer to care for, mentor, teach and have fun with children ages 0 - grade 5. I am interested in serving in Harvest Kids Please rank (1,2,3, etc.) your preferred age group below:Nursery (ages 0-2)1 - Most preferred2345 - Least preferredToddlers (ages 3-4)1 - Most preferred2345 - Least preferredJK-SK (ages 4-5)1 - Most preferred2345 - Least preferredGrades 1-2 (ages 6-7)1 - Most preferred2345 - Least preferredGrades 3-5 (ages 8-10)1 - Most preferred2345 - Least preferredWhat is your T-Shirt size?SMMEDLGXLXXLXXXL Security Information:The following questions are very important, but also very sensitive. Answering ‘Yes’ will not necessarily disqualify you from serving. If you prefer, you may discuss your answers in confidence with a pastor rather than answering them on this form.I would prefer to discuss these questions in confidence with a pastor?YesNo1. Confidential InformationHave you ever been accused or convicted of a crime involving sexual behaviour, abuse/assault, pornography or the use of illegal drugs?YesNoPlease explain1b. Within the last 5 years have you struggled with any of the following? Illegal drugs Alcohol Electronic Pornography Prescription Drugs Tobacco Sexual sin of any kind 2. Family Ministries Background CheckIf you would like to serve in family ministries (kids, youth, young adults), please fill out the volunteer police check form located on our website (www.harvestniagara.ca) or at the Get Connected table, and submit the form to your local police station. Applicants are required by the Niagara Regional Police to submit and pick up their own completed forms. Please present two pieces of government-issued ID. For further details, please visit their website at http://www.nrps.com/records/c2.asp. Please turn in your completed application and police check form at the Get Connected table. Yes, I have already submitted my volunteer police check to the police for processing. 3. Authorization I also authorize any references, churches and others listed in this application to give information (including opinions) which they may have regarding my character and fitness for work with children. I voluntarily release Harvest Bible Chapel and any person, organization from any liability regarding the communication of information regarding my background or qualifications. I am familiar with and agree to adhere to all of the policies and procedures for serving in Harvest Kids. Reference #1: Member of Harvest Bible Chapel(Please do not include family members)Name First Last Email Relationship to YouPhone Reference #2: Friend(Please do not include family members)Name First Last Email Relationship to YouPhone Reference #3: FriendThis reference must be an unrelated adult who has specific knowledge of your character and/or ability to work with children.Name First Last Email Relationship to YouPhone AgreementPlease check the boxes to acknowledge your agreement: I attest and affirm that the information included in this application is both honest and complete in any area where information is requested. I waive any right that I may have to inspect any information provided about me by those I have listed in this application. I give Harvest Bible Chapel permission for photo or video images of myself to be used for promotional purposes at Harvest Bible Chapel. This iframe contains the logic required to handle Ajax powered Gravity Forms.