Application to work with children and young people Personal detailsFirst nameMiddle name(s)Last NameOther names by which known in the pastHouse numberStreet nameCityPostcodeHow long have you lived at this address? If less than 3 years, please give previous address(es), with datesHome phoneMobileEmailExperience and skillsPlease 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 capacityDo you suffer, or have you suffered any illness which may directly affect your work with children or young people? If yes, please give details.ReferencesAt 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 #1Full nameFull addressEmailConnection to youReferee #2Full nameFull addressEmailConnection to youCriminal Records DeclarationBecause 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.If considered suitable for the post, I agree to cooperate in obtaining a DBS check at the Standard or Enhanced levelDeclarationI confirm that the submitted information is correct and complete. 99 plus 1 = leave this one twenty seven thousand