For Staff and Volunteers aged 18 and over. 

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

If "YES" please give details in the space provided or discuss with the Senior Pastor or Safe Church Team Leader. A "YES" answer will not automatically rule you out of ministry. 

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. 

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

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. Referees may be part of the Church but must not be related to you, or be the Minsitry Leader of the ministry you'll be involved in. 

Referee 1:

Referee 2:

By submitting this application, I agree to the following:

I consent to verification of my WWCC number (if required) and a National Police Check (staff only).
 

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. 

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 withhold relevant information from this questionnaire, the church leadership may determine that I am unsuitable to serve in any role in the Church.  
• I have received a copy of the Code of Conduct and am willing to uphold it.