Please circle either “YES” or “NO” for each of the following questions. If you answer “yes” to any of the following questions, please give details on a separate page or discuss with the Senior Pastor or the person holding an equivalent leadership role in your church. 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.

For all staff and volunteers

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

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

CHURCHES YOU HAVE ATTENDED REGULARLY IN THE PAST 3 YEARS

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. Referees may be part of the church.

WORKING WITH CHILDREN CHECK  AND/OR NATIONAL POLICE CHECK

I consent to                

• verification of my WWCC number (in NSW, if required)
• a National Police Check (for staff only)

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.

DECLARATION  

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.