LifeHouse Team Application Form

CONFIDENTIAL Thank you for your interest in becoming part of the LifeHouse team! We exist to love God, love others and walk each step with Christ. Please read carefully through each question as we endeavour to assist you in your journey of servant leadership. If you find any questions difficult, please work through them with your team leader or Pastor.

Corresponding forms and policies can be found at team.life.house listed under "New to the Team"

Your name *

Last name

Email address *

Address *

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Birthdate *

Phone number *

Phone type

Emergency Contact

Emergency Contact Name *

Phone Number *

Relationship to You *

About You

How long have you been attending LifeHouse? *

Were you attending another church before LifeHouse? *

Have you committed your life to Jesus? *

Medical Info

Is there any medical condition, limitation or relevant information that may affect your ability to fully participate as a volunteer? *

Eg. Previous injury, back problems, epilepsy, disability etc.

If you have answered YES please provide details:

Volunteer Teams

If there is a specific team or department you are wanting to or have been asked to serve in, please indicate here:

Clearances and Certificates

Working with Children Checks and other volunteer clearances help keep you and some of our most vulnerable people safe.

Do you have any of the following CURRENT certificates?

Please provide copies (via email info@life.house) of all relevant certificates

WWCC

Teachers Registration

RRHAN

ChildSafe Environments

National Police Check

Food Safety Certificate

First Aid Certificate

Drivers Licence - LR, HR, bus etc

LifeHouse - LifeCode Complete

LifeHouse - Stat Dec Complete

LifeHouse Mandatory Reporting Training

References Provided

Do you have a current Working With Children Check? *

WWCC

Referee 1 - Name *

Referee 1 - Address *

Referee 1 - relationship to this person? *

Pastor, co-worker, friend etc

Referee 1 - Phone Number *

Referee 2 - Name *

Referee 2 - Relationship to this person? *

Pastor, co-worker, friend etc

Referee 2 - Address *

Referee 2 - Phone Number *

Child Protection Statement & Prior Conduct

Working or volunteering with children is not limited to programs/events at church but also events at other locations including being around children in LifeHomes or other ministries held in people’s homes.

Children and young people who are involved in our activities will receive the highest possible standard of care and protection. Therefore, in all our work, we seek to ensure the wellbeing and development of each child and young person.

Within this context, I am committed to the protection of children, young, and vulnerable people from all forms of harm and risk of harm. *

(Please enter your name to sign in agreement with these statements)

Do you agree to read and implement the LifeHouse Child Safe Policy and abide by its conditions prior to working with children or young and/or vulnerable people? *

The policy states that all applicants are required to have a current, valid working with children check. Adults (18 and over) are required to have current RRHAN training and must complete a Statutory Declaration and LifeCode House Team Commitment.

Signature of Applicant

I agree that the information in this application is complete, accurate and not misleading in any way. *

Checking this box and typing your name below is the equivalent of your signature.

I agree to support and act in accordance with the LifeHouse vision and values and to abide by LifeHouse policies and procedures. I will support, respect, honour and encourage all Pastors and Leaders within LifeHouse and associated churches. *

Checking this box and typing your name below is the equivalent of your signature.

I have read and fully understand the My LifeCode House Team Commitment and agree to LOVE, SERVE and GIVE in accordance with this commitment. *

Checking this box and typing your name below is the equivalent of your signature.

I agree to keep up with required training and endeavour to attend LifeHouse Team training events whenever they are offered. *

I agree to complete a Statutory Declaration (if over 18yrs) to be witnessed by a LifeHouse Pastor. *

Checking this box and typing your name below is the equivalent of your signature.

You will be required to disclose to one of our LifeHouse Pastors the following:
- You have ever been interviewed, questioned or charged by police in relation to any offence involving children, young people, theft, violence, alcohol or drugs.
- You have children of your own (under 18) who are not currently in your care.
- You have ever made a Workcover/SafeWork claim and have been unable to work because of it.

Write your full name to agree to this statement: *

Date Applicant Signed *

I am under 18

My parent or guardian must also sign below. The listed below Parent/Guardian is responsible for reading and reviewing all answers submitted as part of this application.

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LifeHouse International
info@life.house
08 8532 1113