Safe Ministry Screening

Safe Ministry Screening Questionnaire

Seaforth Baptist is committed to providing places, services and programs that promote physical, emotional and spiritual health and safety and model the love of Christ to all whom we have contact with, particularly children, young people and vulnerable adults. This safe ministry screening questionnaire is designed to ensure that the church has undertaken appropriate screening processes for all staff and volunteers.

A  ‘yes’ answer does not automatically mean you cannot serve in the church. As much as possible we want to give the opportunity for everyone to serve in the church while also ensuring that the whole community is cared for. As part of our risk management if someone is identified through the Screening Process as a Person of Concern the safety team will respond in accordance with An Australian Baptist Response to Persons of Concern (see the document attached under Safe Church).

Please Note: This is a sensitive document that will be stored in a confidential manner accessible only to the safety team and office admin. A hard copy is available on request if you would prefer.

    Personal Details

    For all staff and volunteers

    Please select either “YES” or “NO” for each of the following questions. If you answer “yes” to any of these questions, please give details below or discuss with the Senior Pastor or the person holding an equivalent leadership role in your church.
    A ‘yes’ answer will not automatically rule an applicant out of selection. 
    Please note that, if you disclose any potentially criminal actions, the church may need to report this information to the police or other relevant government authorities.
    1. Have you ever been charged with and/or convicted of a criminal offence? YesNo
    2. As an adult (18+ years) have you ever engaged in any of the following conduct:
    • sexual contact with someone under your care other than your spouse (such as a parishioner, client, patient, student, employee or subordinate) YesNo
    • use, possession, production or distribution of child abuse material?YesNo
    • sexual contact with a person under the relevant age of consent YesNo
    3. To your knowledge, has there ever been any allegations made against you regarding any abuse of a child, physical abuse or sexual misconduct? YesNo
    4. Have you ever had an apprehended violence order, order for protection or the like issued against you as a result of allegations of violence, abuse, likely harm, harassment, stalking, etc? YesNo
    5. Have you had a history of alcohol abuse or substance abuse (including prescription, over-the-counter, recreational or illegal drugs)? YesNo
    6. (if the ministry role may involve driving) Has your driver’s licence ever been revoked or suspended? YesNo

    Churches you have attended regularly in the past 3 years

    Church One


    Church Two


    Church Three

    Referees

    Referee One


    Referee Two

    Working With Children Check and/or National Police Check

    I consent to:
    verification of my WWCC number (in NSW, if required)a National Police Check (for staff only)

    Consent to hold information

    I sincerely declare that: 
    The information I have provided in this application is true and correct to the best of my knowledge and belief. I understand that if I provide false or misleading information or withhold relevant information from this questionnaire, the church leadership may determine that I am unsuitable to serve in any role in the church.I have received a copy of the Code of Conduct and am willing to uphold it.

      Personal Details

      For all staff and volunteers

      Please select either “YES” or “NO” for each of the following questions. If you answer “yes” to any of these questions, please give details below or discuss with the Senior Pastor or the person holding an equivalent leadership role in your church.
      A ‘yes’ answer will not automatically rule an applicant out of selection. 
      Please note that, if you disclose any potentially criminal actions, the church may need to report this information to the police or other relevant government authorities.
      1. Have you ever been charged with and/or convicted of a criminal offence? YesNo
      2. Have you a history of alcohol abuse or a history of substance abuse including prescription, over-the-counter, recreational or illegal drugs? YesNo
      3. To your knowledge, has there ever been any allegations made against you regarding any abuse of a child, physical abuse or sexual misconduct? YesNo

      Churches you have attended regularly in the past 3 years

      Church One


      Church Two


      Church Three

      Referees

      Referee One


      Referee Two

      Consent to hold information

      I consent to the information contained in this application, including any 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 purposes.

      Declaration

      I sincerely declare that: 
      The information I have provided in this application is true and correct to the best of my knowledge and belief.I understand that if I provide false or misleading information or withhold relevant information from this questionnaire, the church leadership may determine that I am unsuitable to serve in any role in the church.I have received a copy of the Code of Conduct and am willing to uphold it.