Dakota Conference

Sharing the unchanging love of Jesus in a changing world.

Staff/Volunteer Application Form

The Dakota Conference of Seventh-day Adventists,

its churches, schools and camps, is committed to diligently protecting the children in our care. It is because of this commitment that we require permission to conduct a check on each potential employee and volunteer.

Personal Information

Education/Training Information


Information provided

on this form will be kept in the strictest of confidence. Forms retained for permanent record will be kept in a secure location.


List below three individuals (other than family members) who could recommend you for service in Children's Ministries.

Unlawful Conduct

If you answered yes

to either of the above, please give the name and address of a reference/professional who can verify your suitability to work with children.


Please be sure to answer every question and signed your name above. Approved status is ongoing unless concerns that demand investigation become evident in the course of service. To protect your privacy only the front of this form will be returned to the church organization. The original form will be kept in a secure location at the Dakota Conference office.