Volunteer Interest Form If you would like to volunteer with Missionheart please complete the following form and we will be in contact with you. Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress *Best Contact Number *Email *What sort of paid employment have you had, or do you currently do (please list names of employers and roles taken)? *What church do you attend? How long have you been there? What roles do you do there? *What skills do you have that may be relevant to a volunteer role at Missionheart? *What ministry would you like to assist in? *SelectAppointedResourceMissionworx BBQsGathering lunchesDropbears YouthMissionkidzAdministrationOther/unsureDo you have a current first aid certificate? *YesNoPlease provide 2 referees and include their contact details? *(Please answer the following questions with a yes or no. If you answer yes to any of the questions please provide additional information below.) Do you have any health problem(s) which may affect you volunteering for Missionheart? *YesNoHave you ever been charged with and/or convicted of a criminal offence? *YesNoAs an adult (18+ years) have you ever engaged in, even though never having been charged: sexual contact with someone under your care other than your spouse (such as a client, patient, student, employee or subordinate)? *YesNoAs an adult (18+ years) have you ever engaged in, even though never having been charged: sexual contact with a person under the age of consent? *YesNoAs an adult (18+ years) have you ever engaged in, even though never having been charged: sexual abuse (this includes sexual harassment, acts of indecency, non contact and/or contact sexual abuse)? *YesNoAs an adult (18+ years) have you ever engaged in, even though never having been charged: illegal use, production, sale or distribution of pornographic materials? *YesNoAs an adult (18+ years) have you ever engaged in, even though never having been charged: conduct likely to cause sexual harm to people, or to put them at risk of harm? *YesNoTo your knowledge, have you ever been the subject of an allegation of sexual abuse or sexual misconduct? *YesNoHave you ever done anything in the past or present that may result in allegations being made against you of bullying, emotional abuse, harassment, or physical abuse against a child or an adult? *YesNoHave 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.? *YesNoHave you ever had permission to undertake paid or voluntary work with children or other people refused, suspended or withdrawn in Australia or any other country? *YesNoHas 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? *YesNoHas your driver's licence ever been revoked or suspended? *YesNoHave you a history of alcohol abuse or a history of substance abuse including prescription, over the counter, recreational or illegal drugs? *YesNoPlease provide additional information below if you answered yes aboveBy submitting this form I declare that all information is accurate and a truthful representation of my skills, abilities and history. *I agreeEmailSubmit