Team Member Information and Application Agreement Form

Team Member Information and Application Agreement Form
The purpose of this form is to record relevant details to assist in team selection and to prepare for the Program. KPMA will only use personal information for the primary purpose for which it is collected. The information may be disclosed to authorised officers of KPMA to facilitate the KPMA programs. Your personal details will not be revealed or made public, unless you have provided your direct consent.

You can view the Kairos Prison Ministry Australia Privacy Policy on our website here: kairos.org.au/privacy-policy

Filling out this application does not guarantee a position on the team.
Are you applying as a new volunteer to Kairos Prison Ministry Australia?
Which Kairos Program are you applying for?
Please select the KO Region you have been in contact with or are connected to
Kairos Outside Regions
Please select the KI Region you have been in contact with or are connected to
Kairos Inside Regions
Regional Chair Contact Email
This field will be filled automatically
KSO - Region Contacted
Hidden on live form
KSO - Fills Leader email
Hidden on live form - Allows for notification to be sent to Chair and Leader
Leader Email
Hidden on live form.
How did you hear about Kairos?

Other
Contact Information

Your personal information
Name

Prefix (Mr. Mrs etc)First NameLast Name
Preferred First Name (if applicable)
Year of birth
eg: 1965
Gender
Are you Aboriginal or Torres Strait Islander?
Address

Address Line 1

Address Line 2

SuburbState / Territory

Postcode
Is your postal address different to the above?
Postal Address (if different from above)

Address Line 1

Address Line 2

SuburbState / Territory

Postcode
Email (preferred)

Confirmation Emailexample@example.com - email is required to confirm your details.
Email (secondary - if applicable)
example@example.com
Mobile
Please enter a valid phone number.Format: 0000-000-000.
Phone Landline (if applicable)

Area CodePhone Number
Languages other than English
Occupation (optional)
Personal Information

Recorded in the database - for team selection purposes

I attended - Please indicate which Programs you have attended (if any) and in what capacity. Include the most recent date you completed that role in the date column.

Rows	Team	Guest	Observer	Other	Date (most recent)
Kairos Inside
Kairos Outside
Kairos Torch
Emmaus
Cursillo
Other

Church Details - New Volunteer

As part of the application process, we will contact your Church Minister or Ministry Team contact to confirm your church involvement and commitment to the Christian faith. If you are a new volunteer to Kairos, please let your Minister know that you have applied to volunteer with Kairos and that we will be in touch.
Church Name
Church Denomination
Eg: Anglican, Catholic, Baptist etc
Pastor or Ministry Team Contact

First NameLast Name
Pastor or Ministry Team Email
example@example.com
Pastor/Church Phone Number
Please enter a valid phone number.Format: 0000-000-000.
Please list your special gifts and talents
Church Details - existing Volunteer

Please confirm your current church details
Church Name
Church Denomination
Eg: Anglican, Catholic, Baptist etc
Special Needs
Do you have any special dietary needs?
If yes, please provide details of special dietary needs
Do you have any special medical/mobility needs?
If yes, please provide details of special medical/mobility needs
Emergency Contact Name

First NameLast Name
Their relationship to you
Emergency Contacts Phone number
Please enter a valid phone number.Format: 0000-000-000.
Any other comments to make about your special needs?
Australian Capital Territory - Working with Vulnerable People Check
Do you live or will you be volunteering in the Australian Capital Territory (ACT)?
All Kairos volunteers in the ACT are required to obtain a Working with Vulnerable People Check. This check is free for volunteers. If you already have this check, please attach a copy of the back and front of the card below. Alternatively, please give a copy to your Team Leader. If you do not have it yet, please arrange to obtain your check and provide a copy to the Kairos Team Leader.

Front and Back of ACT Working with Vulnerable People Card
Cancelof

Declaration Confirmed - Consent as indicated above and all information is true and correct

Code of Conduct - Confirmation
Name

First NameLast Name
Date

DayMonthYear
Date

Kairos Inside Team Agreement
The Purpose of Kairos

Kairos is an interdenominational Christian ministry to and for prison inmates, their families (Kairos Outside), and juvenile offenders (Torch Program). Our Lord Jesus has commanded Christians to "...go and make disciples of all nations.....teaching them to obey everything I have commanded..." (Matthew 28:19-20).

The principal purpose of Kairos is to carry out that command in one particular environment, the prison, and to share with residents, juvenile offenders and their families, the unconditional love of God in Christ, as presented in the Gospels.

Team members are largely drawn from the Emmaus, Cursillo and like renewal movements within the main stream Christian churches. It is with the utmost importance that the team presents itself to the participants in a unified and cohesive way.

All team members should agree:

1. To affirm the Statement of Faith.

2. To commit to the interdenominational ethos of Kairos, and especially not to proselytise one's own denominational or theological positions.

KAIROS STATEMENT OF FAITH

The people of Kairos are called by God to share the love of Christ with those impacted by incarceration. Kairos encourages believers from a variety of Christian traditions to be volunteers in this Christ‐filled ministry. Kairos programs offer to prison residents, their families, and those who work with them, the opportunity to receive God’s forgiveness through faith in Jesus Christ, and to grow in their faith and servant‐hood in Christian community.

We stand on the common ground of the following elements of faith:

We in Kairos believe:

•        The Bible is God’s authoritative and inspired word for our faith and our lives.

•        In the Trinity of the Father, Son, and Holy Spirit.

•        In the deity, death, and resurrection of Jesus Christ.

•        Friendship with God is a free gift, for God so loved the world that He gave His one and only Son so that whoever believes in Him shall not perish but have eternal life.

•        The love of Jesus Christ motivates His followers to provide food for the hungry, drink to the thirsty, welcome to the stranger, clothes for the naked, and visits to the sick and those in prison.

•        In sharing the love and forgiveness of Jesus Christ with all incarcerated individuals, their families, and to those who work with them inside and outside the correctional institution.

VISION

A community spiritually freed from the effects of imprisonment reaching all impacted by incarceration, through the love, hope and faith found in Jesus Christ.

MISSION

The mission of the Kairos Prison Ministry is to share the transforming love and forgiveness of Jesus Christ to impact the hearts and lives of incarcerated men, women and youth, as well as their families, to become loving and productive citizens of their communities.
Agreement and Signature of Applicant

A mandatory Team Formation period is required in preparation for each Kairos Course. Its primary purpose is to unify the Team in the Spirit of Christ. This Team Formation period is highly structured with a well‐defined agenda. The Team learns about the prison environment and current rules of the prison.

Specific tasks pertaining to the program are defined, explained, and assigned during the Team Formation. Team service also includes the participation in Kairos’s continuing ministry ‐ such as monthly meetings at the prison.

I agree to:
- I agreed to make every effort to attend all Team Formations and I understand that if I miss more than 25% of these meetings, I will be dismissed from the team;
- Participate in the Continuing Ministry of Kairos;
- Abide by the rules and policies of Kairos and the Prison;
- Take the Manual, read the Manual and follow the program as it is presented in the Manual with no unauthorised additions or deletions.
- Support, in good faith, the Kairos activities, as well as the theological and scriptural content of the talks as outlined in the Kairos Inside Manual;
- Abide by the rules of confidentiality;
- Pay the voluntary team contribution as indicated in the Leader’s letter. (If fundraising excludes team contributions)(If I am not financially able to do so, I can discuss matters with the leader. Finances are not a barrier to being on team).
KI Agreement
Name (KI)

First NameLast Name
Date

DayMonthYear
Date
I am applying for:

Kairos Outside Team Agreement
The Purpose of Kairos and Kairos Outside

Kairos is an interdenominational Christian ministry to and for prison inmates and their adult family members and friends. Team members are largely drawn from the Emmaus and Cursillo movements within the mainstream Christian churches. Our Lord Jesus has commanded Christians to ‘go and make disciples of all nations teaching them to obey everything I have commanded’ (Matt 28:19‐20). The principal purpose of Kairos is to carry out that command in one particular environment, the prison, and to share with inmates the unconditional love of God in Christ, as presented in the Gospels.

Kairos Outside extends that vision to female friends and family members of current or past prisoners. The purpose of Kairos Outside is to demonstrate God’s grace and love through Christian support for women who have relatives/friends who are or have been in prison , and to former female residents of correctional institutions who did not have the opportunity to attend a Kairos Inside program while they were in prison.

All Kairos Outside team members must agree:

1. To affirm the Kairos Statement of Faith

2. To abide by the rules and policies of Kairos including requirements for confidentiality, commitment to the Code of Conduct and service in good faith in any role assignment.

3. To stay within the ethos of the Kairos Outside manual and follow its guidelines.

KAIROS STATEMENT OF FAITH

The people of Kairos are called by God to share the love of Christ with those impacted by incarceration. Kairos encourages believers from a variety of Christian traditions to be volunteers in this Christ‐filled ministry. Kairos programs offer to prison residents, their families, and those who work with them, the opportunity to receive God’s forgiveness through faith in Jesus Christ, and to grow in their faith and servant‐hood in Christian community.

We stand on the common ground of the following elements of faith.

We in Kairos believe:

•        The Bible is God’s authoritative and inspired word for our faith and our lives.

•        In the Trinity of the Father, Son, and Holy Spirit.

•        In the deity, death, and resurrection of Jesus Christ.

•        Friendship with God is a free gift, for God so loved the world that He gave His one and only Son so that whoever believes in Him shall not perish but have eternal life.

•        The love of Jesus Christ motivates His followers to provide food for the hungry, drink to the thirsty, welcome to the stranger, clothes for the naked, and visits to the sick and those in prison.

•        In sharing the love and forgiveness of Jesus Christ with all incarcerated individuals, their families, and to those who work with them inside and outside the correctional institution.

VISION

A community spiritually freed from the effects of imprisonment reaching all impacted by incarceration, through the love, hope and faith found in Jesus Christ.

MISSION

The mission of the Kairos Prison Ministry is to share the transforming love and forgiveness of Jesus Christ to impact the hearts and lives of incarcerated men, women and youth, as well as their families, to become loving and productive citizens of their communities.

Note: that when tasks are assigned, the Leader will endeavour to recognise and employ the gifts of individual team members. However, in volunteering, you signify your willingness to accept any role the Leader assigns to you.

As a member of a Kairos Outside team you will need to:

1. Obtain a current Kairos Outside Manual and become familiar with your responsibilities. Take the Manual, read the Manual and follow the program as it is presented in the Manual with no unauthorised additions or deletions.

2. Undertake to attend all team formation, the Kairos Weekend itself and the reunions that follow.

3. Commit to the Kairos Outside activities for 6/12 months following the Weekend.

4. Agree to support, in good faith, the weekend activities, as well as the theological and Scriptural content of the talks as outlined in the Kairos Outside Manual.

5. Abide by the rules of confidentiality.

6. Pay the voluntary team contribution as indicated in the Leader’s letter. (If fundraising excludes team contributions) (If I am not financially able to do so, I can discuss matters with the leader. Finances are not a barrier to being on team).

I acknowledge that I have read and agree to abide by the Statement of Faith, Purpose of Kairos and the Kairos Prison Ministry Australia (KPMA) Code of Conduct Summary.
KO Agreement
Name (KO)

First NameLast Name
Date

DayMonthYear
Date
I am applying for:

Agreement
By submitting this application and signing below, you agree to be considered as a Kairos Prison Ministry Australia volunteer and for your details above to be used to assess your suitablility for a role including contacting your church reference (if a new volunteer). If successful, you agree to your contact information being used for team communication, program updates, meeting notes, volunteer newsletter, Kairos general communications and other internal communications inline with our Policies and Procedures. Your information will not be shared with organisations outside of Kairos Prison Ministry. You can view our Privacy Policy on our website: kairos.org.au/privacy-policy/

You may update your details anytime by contacting the Kairos Support Office.

I, {name} confirm I agree to the above:
Signature

Sign with your mouse or with finger on touch screen or select type to use keyboard
Date

DayMonthYear
Date of signing
Should be Empty:

Rows	Agree	Disagree
Understanding that my details can be removed from the KPMA database at any time on request.
My details to be provided for team selection or relevant involvement in Kairos.
To receive Kairos information and notifications regarding news, events and relevant information.
For my church minister as listed above to be contacted (new volunteers).
Agree to be included in a team photo for use in Volunteer News and possibly Kairos News page on the website.

Rows	Agree	Disagree
Understanding that my details can be removed from the KPMA database at any time on request.
My details to be provided for team selection or relevant involvement in Kairos.
To receive Kairos information and notifications regarding news, events and relevant information.
For my church minister as listed above to be contacted (new volunteers).
Agree to part of a group photo (with Guests) given to those who attend a Kairos Outside Weekend (provided in a booklet given to all who attend the weekend with you).
Agree to be included in a team photo of volunteers (not including Guests) for use in the Volunteer News and possibly Kairos News page on the website.

Team Member Information and Application Agreement Form

Contact Information

Personal Information

Church Details - New Volunteer

Church Details - existing Volunteer

Special Needs

Australian Capital Territory - Working with Vulnerable People Check

Kairos Inside Team Agreement

Kairos Outside Team Agreement

Agreement