Volunteer Screening Questionnaire Application (under 18 yrs old) • Ashfield Baptist Church

Volunteer Screening Questionnaire Application (Under 18 years old)

This form is a legal requirement and supports our desire to create and maintain a safe church for our community, Ashfield and beyond.

Please DO NOT push 'ENTER' until you are ready to submit this form. Please TAB or selct each field with your mouse.

In what role are you interested in serving at Ashfield Baptist Church?

Role *

Tip: ie: youth, children, congregational care etc...

Part A General Information

We believe that the Holy Spirit enables us to serve God and each other through our gifts and abilities, time and resources. We also believe that serving alongside other people is one of the best ways to get connected to the community of faith here at ABC, and one of the ways we join in with all God is doing in the world.

By completing the questions below, you will help us discern, together with you, where God might be calling you to serve at ABC at this time. We look forward to seeing where and how God will use you, in the life of our church community.

First Name *

Last Name *

Gender

Date of Birth

Email Address

Phone Number

Mobile Number

Home Address

Home City

Home State

Home Postcode

Name of at least one Parent/Guardian: *

Contact phone for Parent/Guardian: *

Do you have any health conditions that we should know about? If so, please set out below (or leave blank)

PART B | Safety Questions

Please answer “YES” or “No” to each of the following questions. If you answer “yes” to any one of these questions, please provide details in the text box at the bottom of the section, or discuss with the Leader responsible for this role. A “yes” answer will not automatically rule an applicant out of selection.

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

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

Yes

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

Yes

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

Yes

IF YOU ANSWERED "YES" TO ANY OF THE QUESTIONS ABOVE, PLEASE BRIEFLY PROVIDE DETAILS HERE:

Churches You Have Regularly Attended in the Past Three Years

Please list the details of the churches that you have regularly attended over the past three years, starting with the most recent church.

If this is ABC, please put this down.

Name of most recent church and location: *

When *

Any positions held:

Second Church

Name of church and location:

When:

Any positions held:

Third Church

Name of church and location:

When:

Any positions held:

Referees

Please provide the details of TWO referees. These referees must meet the following criteria:

They are ideally in an existing leadership role at ABC.
They cannot be a relative.
They must be over the age of 18 years old.
They need to have known you for a minimum for 12 months in order to report on your character.

Referee ONE:

Contact Details:

Referee TWO:

Contact Details:

Declaration

CONSENT TO HOLD INFORMATION

I consent to the information contained in this application, including any subsequent page/documents, to be kept by Ashfield Baptist Church. I understand that this information will be kept in a confidential file and used only for screening purposes.

By entering my name and the date below, I 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 withhold relevant information from this application, the church leadership may determine that I am unsuitable to serve in any role in the church; and
I understand that prior to commencing any ministry role, I will be required to read and sign a Code of Conduct.

Name:

Date: