Ministry Application Form • Narara Valley Baptist Church

Adult Ministry Application Form (Volunteers aged 18yrs+)

This Ministry Application is supported by the NVBC Code of Conduct and Safe Church Policy available at www.nvbc.info/policies. As part of this application, the applicant must read the aforementioned policies and return a signed copy of the Code of Conduct with this application.

Completion of this form, and a Working with Children application is an essential requirement if you wish to be involved in ministry at Narara Valley Baptist Church. If you choose to not complete this form the official position of Narara Valley Baptist Church is that no inference will be drawn from this decision, but your application will be unable to continue. THE INFORMATION ON THIS FORM IS USED FOR CHILD PROTECTION and MINISTRY TEAM SCREENING ADMINISTRATIVE PURPOSES ONLY.

Please note: This is a sensitive document that will be stored in a confidential manner accessible only by a limited number of authorised persons.

First Name *

Last Name *

Previous Name/s (if applicable)

Home Address *

Home Address Line 2

Home City *

Home State *

Phone Number

Home Postcode *

Mobile Number *

Email Address *

Do you have any medical issues you would like us to be aware of? *

Yes

Medical Notes *

Working With Children Check Number (or application number if still in process)

If you don't not have a Working With Children Number please go to ..... This is free to obtain.

Application OR Working With Children Check Number

Name that Working with Children Check was completed with

WWCC Expiry Date

Date of Birth

What area of ministry/ministry position do you wish to be involved in? *

Why do you want to be involved with this ministry? *

Gift and Abilities: List the gifts and abilities that you would bring to your volunteer work. *

Please select either "YES" or "NO" for each of the following questions.

If you answer "yes" to any of the following questions, please use comments section below each answer or discuss with the Senior Pastor.

A 'yes' answer will not automatically rule an applicant out of selection.

Please note that, if you disclose any potentially criminal actions, the church may need to report this information to the police or other relevant government authorities.

1. Have you ever been charged with and/or convicted of a criminal offence? *

Yes

2. As an adult (18+ years) have you ever engaged in any of the following conduct: *

Yes

Sexual contact with someone under your care other than your spouse (such as a parishioner, client, patient, student, employee or subordinate)? *

Yes

Use, possession, production or distribution of child abuse material? *

Yes

Sexual contact with a person under the relevant age of consent? *

Yes

3. To your knowledge, has there ever been any allegations made against you regarding abuse of a child, physical abuse or sexual misconduct? *

Yes

4. Have you ever had an apprehended violence order, order for protection or the like issued against you as a result of allegations of violence, abuse, likely harm, harassment, stalking etc? *

Yes

5. Have you ever had a history of alcohol abuse or substance abuse (including prescription, over-the-counter, recreational or illegal drugs? *

Yes

6. (if the ministry role may involve driving) Has your drivers license ever been revoked or suspended? *

Yes

For Staff and volunteers in pastoral ministry, leadership or engaged in child-related work or work with vulnerable adults.

7. Have you ever had permission to undertake paid or voluntary work with children or other vulnerable people refused, suspended or withdrawn in Australia or any other country? *

Yes

8. Has a child or dependant young person in your care ever been removed from your care by relevant authorities? *

Yes

CHURCHES YOU HAVE ATTENDED REGULARLY IN THE PAST 3 YEARS

Church Name:

Period Attending:

Church Name:

Period Attending:

Have you held any positions in these previous churches?

REFEREES

Please provide details of two referees who are over eighteen years of age and able to give a verbal report on your character and suitability for ministry. Please include a Pastor, Elder or Leaders from NVBC (you can leave their phone number bank)

Referee 1

Name

Phone

Relationship

Referee 2

Name

Phone

Relationship

WORKING WITH CHILDREN CHECK

I consent to the verification of my WWCC number

Yes

CONSENT TO HOLD INFORMATION

I consent to the information contained in this application, including any subsequent pages, to be kept by our church. I understand that this information will be kept in a confidential file and used only for screening purposes.

Yes

DECLARATION

I sincerely declare that :

The information I have provided in this application is true and correct to the best of my knowledge and belief.
I understand that if I provide false or misleading information or withold relevant information from this application, the church leadership may determine that I am unsuitable to serve in any role in the church.
If any of the information that I have provided in this form changes or I am subject to investigations or convicted of a criminal offence, I will notify my Ministry Leader.
I have received a copy of the Code of Conduct and am willing to uphold it.
I have read and understood the Narara Valley Baptist Church Safe Church Policy.

By confiming below and entering today's date you commit to this declaration.

I commit to this declaration *

Date *

Ministry Application Form (Volunteers 18yrs+)