Application form

Application form - Slough Baptist Church

For those wishing to work with children, young people or vulnerable adults
Full Name

First NameLast Name
Birth Date

MonthDayYear
Who will you be working with?
Address

Street Address

Street Address Line 2

Town/CityState / Province

Post Code
Previous addresses (last 5 years) including post codes
Phone Number (landline)
Phone Number (mobile)
E-mail
Previous churches (last 5 years)
References
Please give the names and contact details of two people who know you well and would be able to give you a personal reference. These can be people from the church but not members of your own family.
Reference 1 - name

First NameLast Name
Phone Number
E-mail
Reference 2 - name

First NameLast Name
Phone Number
E-mail
Declaration
We ask you to sign the following declaration to indicate that you understand it is a great responsibility to work with children and young people and recognise the need to ensure their safety.
Have you ever been convicted of a criminal offence, been charged with a criminal offence or been subject to a criminal investigation, or are you currently subject to an investigation ?
If yes, please give details of any offences against children, young people or vulnerable adults or any offence including sexual activities or violence. Please also state details of any drugs related offences.
(including dates)
Have there ever been any allegations made against you by children, young people or vulnerable adults alleging sexual or violent misconduct?
If yes, please give details
You may be asked to provide further details, but having a criminal conviction on its own (apart from convictions of abuse against a minor) will not disqualify you from working with young people as a volunteer.
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, young people or vulnerable adults within the church.
By submitting this application to be a volunteer you are committing yourself to abide by the church’s policy and procedures, 03 Safeguarding Policy and Procedures, where work with children, young people and/or adults at risk will be subject to a Disclosure & Barring Service (DBS) check and you agree to undertaking the safeguarding training required.
Date

DayMonthYear
Should be Empty:

Application form - Slough Baptist Church

References

Declaration