Application to Volunteer 16yrs+ • Hervey Bay Baptist Church

This form is to be completed by all applicants over the age of 16yrs for any voluntary positions within Hervey Bay Baptist Church.

Personal Information

First Name *

Last Name *

Gender

Date of Birth *

Have you been known by any other name/s? *

Yes

Previous Name/s:

Home Phone Number

Mobile Number *

Email Address *

Mailing Address

Mailing Address *

Mailing Address Line 2

Mailing City *

Mailing State *

Mailing Postcode *

Home Address (If different from mailing)

Home Address

Home Address Line 2

Home City

Home State

Home Postcode

Activities

What are the names or types of activities you are interested in being involved in and why? *

What date are you available to begin? *

Are you willing to commence your involvement on a trial basis, to be reviewed at the completion of a 10-week period? *

Yes

What is your minimum length of commitment?

Are you willing to complete required training provided by the church relevant to ministry involvement? *

Yes

Church Involvment

How long have you been attending Hervey Bay Baptist Church? *

Are you a member of Hervey Bay Baptist Church?

Yes

Name all churches you have attended or been involved in during the past 5 years and the length of service. *

List all previous involvement in church roles involving vulnerable people (identify which church next to the type of work).

List any gifts, training, qualifications, or any other facts that have prepared you for working with vulnerable people. (eg. Spiritual Gifts, First Aid/CPR, tertiary qualifications etc).

Overseas Status

Have you lived or worked overseas for more than 12 months in the past 5 years?

Yes

Where?

Do you consent to a criminal history check in these countries?

Yes

Please list countries

Referees (2 required) preferably not related to applicant

Reference 1 Name *

Reference 1 Phone Number *

Reference 1 Email *

Reference 2 Name *

Reference 2 Phone Number *

Reference 2 Email *

Blue Card & Safe Church Information

If your application proceeds, do you consent to the Church linking your Blue Card? *

Yes

Restricted Person and Restricted Employment

A restricted person is a person who:

has been issued a negative notice, or
has a suspended blue card, or
is a disqualified person, or
has been charged with a disqualifying offence which has not been finalised.

Restricted employment refers to particular exemptions which allow a person to work with children without a blue card, such as:

a volunteer parent;
a volunteer who is under 18;
paid or unpaid staff who work in child regulated employment for not more than 7 days in a calendar year; or
a consumer at a child-related service outlet* where they also carry out work at the outlet.

*A child-related service outlet means a place at which disability services are provided to children.

If you are a restricted person:

you must not start or continue to work in restricted employment.
if you currently work in restricted employment, you must immediately stop or you will be breaking the law and can be prosecuted.
you do not need to tell the organisation the reason why you are no longer able to volunteer or work for them. However, you must immediately stop working or volunteering with the organisation or you will be committing an offence and can be prosecuted.

It is prohibited to start or continue in restricted employment if you are a restricted person. The maximum penalty is $68,925 (500 penalty units) or 5 years in prison. Penalties will also apply to organisations.

Are you a Restricted Person? *

Yes

Medical Information

Medicare Number

Any medical conditions which may impact your ability to fulfill your voluntary role?

Any physical or other conditions/limitations which may impact your ability to fulfill your voluntary role?

Applicant's Statement

The information contained in this application is correct to the best of my knowledge. I authorise the organisations or individuals listed in this application to give you any information they may have regarding my character and fitness for working with children and my involvement in Hervey Bay Baptist Church ministries. Should my application be accepted, I agree to be bound by any policies/procedures of Queensland Baptists and Hervey Bay Baptist Church and refrain from unscriptural conduct in the performance of my services on behalf of the church.

I have been provided a copy of and agree to abide by the following: *

The HBBC Code of Conduct

The HBBC Safe Church Strategy

By signing the application form, I understand the following: *

I am consenting to the screening process

I am agreeing to participate in the mandatory training (online and/or in-person) should my application be accepted

Holding a Blue Card or an Exemption Card does not automatically make me suitable for serving in ministry at Hervey Bay Baptist Church

It is an offence for a ‘disqualified person’ to sign a blue card application form or a renewal form

It is an offence for a staff or volunteer to fail to notify Blue Card Services on the appropriate form of any change in personal details within 14 days

Applicant's Name *

Application Date *