APPLICATION UNDER 18 Volunteer NSWACC SRE

NSW ACC Volunteer SRE Teacher

Application for Under 18 year old teachers
Your Name*

Last NameFirst Name
Address*

Street Address

Street Address Line 2

CityState

Postal Code
Phone Number*

+612Phone Number
Email Address*
Email
I am applying for*

1 year authorisation ($20)3 year authorisation ($45)
I'm seeking to be engaged in these schools*
Full name including High, Middle or Primary
The Curriculum used is*
I will be teaching:*
My SRE Supervisor is*
This is the person who will be in the room with you at all times.
SRE Superviosor Denomination AND Church name*
SRE Supervisors email*
SRE Supervisors Phone Number*
Your Pastor's name *
Denomination*
Name of your church*
Suburb/Town of your church*
Name of your parent/guardian giving you permission to teach SRE*
Parent/Guardian phone number*
Parent/Guardian email address*
Upload Parent/Guardian Declaration (download from https://www.nswacc.org.au/_files/ugd/261d17_606ce3e3ff3a4a0c9755b25067097eb0.pdf)*

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Your Pastor's email *
Attach Pastor's Reference (Download this from NSWACC website: https://www.nswacc.org.au/_files/ugd/261d17_5a8e91943eda4c5296980aa0d69f230e.pdf)*

Upload a File
Max Total Upload Size: 500MB Cancelof
A copy of my church's Volunteer Workers Compensation Insurance is held by NSWACC SRE. If no, please email a copy to: sre@nswacc.org.au*

YesNo
Your Date of Birth*
Attach Safer Churches Certificate. Must be dated within the past 3 years.*

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Safer Churches expiry*
3 years after date on certificate
Attach SRE Teacher Training Certificate. Must be dated within past 3 years.*

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I have read and understand the ACC Complaints Process. https://www.nswacc.org.au/_files/ugd/261d17_08967d62256b4e8bb848ae59e2d3069d.pdf*

YesNo
I have read and agree to uphold the ACC Volunteer Code of Conduct. https://www.nswacc.org.au/_files/ugd/261d17_8af6b42b9a474432b68187619bfe5842.pdf*

YesNo
Upload your signed ACC Volunteer Code of Conduct here.*

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Please email sre@nswacc.org.au for a copy of the Under 18 Conviction Declaration. Sign the Conviction Declaration and upload it here. If you are not able to sign this form, contact sre@nswacc.org to find out the next step.*

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I understand that if I am charged with a crime against a minor, or violence, or sexual assault or provision of prohibited drugs I will IMMEDIATELY inform sre@nswacc.org.au*

I will.I will not.
Payment can be made via bank transfer.

Account Name: ACC NSW

Reference: SRE 'surname' 'first initial' (eg. SRE Jones B)

Bank: Commonwealth Bank

BSB: 062 000

Account Number: 15234519
Date payment was made*
Amount Paid*

$20 for one year authorisation$45 for three year authorisation
Should be Empty:

NSW ACC Volunteer SRE Teacher