Application to work with children and young people

We ask all prospective workers with children and young people (0-18) to complete this form. The information will be kept confidentially by the church, unless requested by an appropriate statutory authority.

Personal details

First name

Middle name(s)

Last Name

Other names by which known in the past

House number

Street name

City

Postcode

How long have you lived at this address?

If less than 3 years, please give previous address(es), with dates

Home phone

Mobile

Experience and skills

Please tell us about your Christian experience (i.e. how long have you been a Christian, which church(es) have you attended (with dates), any activities undertaken)

Please give details of previous experience of looking after or working with children and/or young people. Please include details of any relevant qualifications or appropriate training either in a paid or voluntary capacity

Do you suffer, or have you suffered any illness which may directly affect your work with children or young people? If yes, please give details.

References

At least one referee should be external to the church. If you have experience working with children and/or young people, at least one referee should be a colleague with whom you have worked. If you have moved from another church in the past five years, one referee should be from your previous church. In addition, we reserve the right to take up character references from any other individuals deemed necessary.

Referee #1

Full name

Full address

Connection to you

Referee #2

Full name

Full address

Connection to you

Criminal Records Declaration

Because of the nature of the duties you will be expected to undertake, applicants will be required to cooperate in obtaining a Standard or Enhanced Disclosure from the Disclosure and Barring Service. Because of the nature of the work for which you are applying, this position is exempt from the provision of section 4(ii) of the Rehabilitation of Offenders Act 1974 (Exceptions Order 1975), and you are therefore not entitled to withhold information about convictions which for other purposes are ‘spent’ under the provisions of the 1974 Act and in the event of appointment, any failure to disclose such convictions could result in the withdrawal of approval to work with children and/or young people within the church.

Declaration

I confirm that the submitted information is correct and complete.

99 plus 1 = leave this one twenty seven thousand