Gender *
Select… Male Female
Phone number *
Phone type Mobile Home Work Other
What church(es) did you attend before CrossCulture Tarneit? *
Please answer "N/A" if CrossCulture Tarneit is the first church you attend
What ministries or positions have you served in your previous church(es)? *
Feel free to answer "N/A" if you didn't serve in your previous church(es)
Which ministry/ies are you interested in volunteering in? *
1. Do you have any health problem(s) which may affect you volunteering/working for the church? *
2. Have you ever had permission to undertake paid or voluntary work with children or other vulnerable people, refused, suspended or withdrawn in Australia or in any other countries? *
3. Have you ever been convicted of a criminal offence? *
4. Have you been charged with a criminal offence? *
5. Have you ever engaged in any of the following conduct even though never been having been charged? *
a. Sexual contact with someone under your care other than your spouse (such as parishioner, client, patient, student, employee or subordinate) b. Sexual contact with a person under the age of consent c. Illegal use, production, sale or distribution of pornographic materials d. Conduct likely to cause harm to people, or to put them at risk of harm
6. Have your driver's license ever been revoked or suspended? *
7. Have you ever had an apprehended violence order, order for protection of the like issued against you as a result of allegations of violence, abuse, likely harm, harassment, stalking,..etc? *
8. Has a child or dependent young person in your care (as a parent or in any other capacity) ever been removed from your care, or been the subject of a risk assessment by the authorities? *
9. Have you done anything in the past or present that may result in abuse allegations being made against you? *
(Abuse includes bullying, emotional/psychological abuse, harassment, neglect, physical abuse, sexual abuse, elder abuse, domestic/family violence)
10. To your knowledge, have you ever been the subject of an allegation of sexual abuse or sexual misconduct? *
11. Have you a history of alcohol abuse or a history of substance abuse including prescription, over-the counter, recreational or illegal drugs? *
12. Have you a history of alcohol abuse or a history of substance abuse including prescription, over-the counter, recreational or illegal drugs? *
13. If you answer Yes to any question 1 to 12 above, please provide details below. *
Referee no. 1 *
Please provide the person's First Name, Last Name, Contact no. and Email address.
Referee no. 2 *
Please provide the person's First Name, Last Name, Contact no. and Email address.
What is the expiry date of your WWCC?
Kindly upload a copy of your WWCC
Choose 1 file. Maximum file size 10 MB.
1. I understand the above Code of Conduct and I agree to uphold the standards of behaviour described in it. I understand that disciplinary measures and legal steps will be taken by the church if I am found to be in breach of the Code of Conduct. This will include reporting to the relevant authorities. 2. I consent to the information contained in this Application to Volunteer Form is 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. 3. I consent to provide a Criminal Background Check and/or a Working with Children Check. 4. I declare that the information I have provided in this application and the information contained in any document accompanying this application are true and correct to the best of my knowledge and belief. 5. I understand that any material misstatement in or omission from this questionnaire may render me unfit to hold a particular or any office in the Church.
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