Volunteer Declaration and Code of Conduct
Name
First Name
Last Name
Date of Birth
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Criminal History Check
I hereby consent to an Australian Federal Police Check if one is considered necessary for my role.
Please Select
Yes
No
I hereby consent to an Australian Federal Police Check if one is considered necessary formy role.
Consent to Hold Information
I consent to the information contained in this application including the 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 and disciplinary purposes.
Please Select
I consent
C3 Belconnen Volunteer Code of Conduct
Declaration For Service
1. I understand that the church operates in an environment of numerous legal and ethical restrictions, and I will fully cooperate with the church in abiding by these. I assure the church, in considering me for a volunteer role that:
• I have no health impediment that will put me or any other person at risk in the fulfilment of my designated role
• I know of no past behaviour that renders me unfit to serve as a volunteer or which detracts from the obligation of the church to operate as a place of safety to a minor or any other person. Such past behaviour may include being the subject of an allegation of sexual abuse (whether convicted or not), including any type of molestation, indecent exposure, sexual harassment or intimidation.
*
Yes
2. I understand that if I am unclear as to any of the statements in this document, I will seek clarification from a team leader or church leader before signing.
*
Yes
3. I have provided this information, and any documents accompanying it in good faith and declare they are true and correct to the best of my knowledge and belief.
*
Yes
4. I understand that any material misstatement in or omission from this questionnaire may render me unfit to hold a particular role in the church
*
Yes
5. I have read the Volunteer Code of Conduct below and I agree to uphold it.
*
Yes
6. I understand that when considering whether there is an avenue for my voluntary services, my church may refer to their policies. Procedures and Guidelines.
*
Yes
7.I will respect the decision of my church as to where I volunteer my services within the church, and whether my services are required, from time to time.
*
Yes
8. I understand that a team leader will be available to me to discuss my service.
*
Yes
Proposed Volunteer Signature
Date
-
Month
-
Day
Year
Date
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