Safe Sanctuary

Safe Sanctuary Application

This application is to be completed by all applicants for any position (volunteer or compensated) involving the custody of minors or the developmentally disabled. This is not an employment application form. Persons seeking a position in the church as a paid employee will be required to complete an employment application in addition to this screening form. It is being used to help the church provide a safe and secure environment for those children, youth, or developmentally disabled who participate in our programs and/or use our facilities.

This information is used for internal purposes only, by this congregation of the United Methodist Church.

Along with this application, you must read our policy and complete the online Safe Sanctuary training provided by the Kentucky UMC Annual Conference.

The information contained in this application is correct to the best of my knowledge. I understand it may be cause for dismissal if it is found the answers given are untrue. I authorize any references or churches listed in this application to give you any information, including opinions that they have regarding my character and fitness for children, youth, or developmentally disabled ministry. In consideration of the receipt and evaluation of this application by Wilmore United Methodist Church, I hereby release any individual, church, youth organization, charity, employer, reference, or any other person or organization including record custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature which may at any times result to me, my heirs, or family on account of compliance or any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application.

Should my application be accepted, I agree to be bound by the Bylaws of Wilmore United Methodist Church, and to refrains from unscriptural conduct in the performance of my services of behalf of the church.

I have asked the following persons, not relatives, to submit a reference form on my behalf. Please list at least one former or present employer, if possible. I waive any and all rights to view these references at any time.

This link will direct you to a reference form that needs to be completed by the references you have listed above. If the reference would rather a print form, please download and print pages 5–6 of the application form here and mail the completed form to the address below. Please remember that you have waived your right to see these reference forms.

Reference Form—Online Form
Reference Form—PDF

Missional-Discipleship Pastor
Wilmore United Methodist Church
209 East Main Street
Wilmore, KY 40390