Calvary Christian Academy

School Entry Form

Your name *

Last name

Email address *

Phone number *

Phone type

Birthday *

Gender *

Do you attend CalvaryPSL Church? *

Where are you interested in volunteering? *

All Calvary Christian Academy Volunteers are required a level II finger printing background check. The price of fingerprinting is $75.00. Each year thereafter an annual standard Criminal Back-Ground Check is required and will be processed by Calvary PSL at no additional cost.

Field Trip Chaperone

Hall Monitor (Secured Ministry Team)

Homeroom Parent

PAWS Volunteer

Special Events

Therapist

Other

If you are a Therapist, list your company's name, address, and phone number here:

References (Non-Related)

Please list 3 people that is not a family member that we may contact who know your spiritual and/or personal character. (Examples: Friends, Co-Workers, Neighbors, Calvary Group members, etc.)

Reference #1: *

Name
Relationship to you
Years Known
Contact Phone #
Address

Reference #2 *

Name
Relationship to you
Years Known
Contact Phone #
Address

Reference #3 *

Name
Relationship to you
Years Known
Contact Phone #
Address

Have you ever been convicted or plead guilty before a court of any Federal State, or Municipal Criminal Offense? *

(EXCLUDING MINOR TRAFFIC VIOLATIONS)

Yes

If Yes, Please explain:

Have you ever received deferred adjudication or similar disposition for any Federal, State or Municipal Criminal Offense? *

Yes

If Yes, Please explain:

Have you ever received probation or community supervision for any Federal, State or Municipal Criminal Offense? *

Yes

If Yes, Please explain:

Have you ever received probation or community supervision for any Federal, State or Municipal Criminal Offense? *

Yes

If Yes, Please explain:

Have you ever been convicted of any criminal offense in a country outside the jurisdiction of the United States? *

Yes

If Yes, Please explain:

As of the date of this Application, Do you have any pending criminal charges against you? *

Yes

If Yes, Please explain:

Have you ever served in the US Military? *

Yes

If you have been discharged from the Military, Did you receive an Honorable Discharge?

Yes

If No, Please explain:

By entering your name below you are electronically signing that the information provided is correct. *

Applicant's Signature & Date

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Calvary Port St. Lucie
772-871-1702