Response Pastor - Application Form

Response Pastor - Application Form

1.Introduction

Response Pastors requires that each volunteer is:

1. a professing Christian;
2. an active Street Pastor;
3. has a current support reference from their church minister/pastor and application has been discussed with co-ordinator.

Applicant’s details:
First name: ______ Last name:______
Address:______
email: ______
Telephone: ______Mobile:______
DBS [date , number ], signed up to on-line update service tick□, have street pastor ID card -tick□
Street Pastor Group: ______
Coordinator’s section:
This section must be completed with details of your Street Pastor Co-ordinator (or management team member), who should be supportive of your application. The co-ordinator is requested to endorse support or otherwise.

• Street Pastor Co-ordinator(name): ______
• Street Pastor Group: ______
• email: ______
• Telephone: ______

Co-ordinator comments: Confirm applicant has; signed volunteers agreement; signed they have read the code of conduct, media and safeguarding policies, also has a current minister reference andup to date[within last three years] DBS (more space on page 4):
Response Pastor Tabard Size required: / S / M / L / XL / XXL
Are you involved in any form of ministry in your church or in some other Christian organisation, e.g. Children/Youth work, Teaching, Leading Worship, Administration, Community Work, Hospitality, etc. If Yes, please state clearly what this involves:
Please state your reasons for wanting to be a Response Pastor:
What are your expectations from the Response Pastor’s deployment as part of the team?

2.Your Skills

Do you have an up-to-date First Aid Certificate? / Yes / No
Do you possess any other skills, which may be useful as a Response Pastor?

3.Your Health

Do you suffer from any medical condition we need to be aware of? / Yes / No
Are you currently on any medication? If so, please give details: / Yes / No
Are you subject to any dietary restrictions? / Yes / No

4.Emergency Contact

Emergency details 1
Name: / Home No.
Relationship / Mobile No.
Address
Declaration:
I confirm that I have signed the volunteer’s agreement; completed a confidential self declaration form and have a ID card and currentDBS (within last 3 years). To the best of my knowledge the information given in this application form is true and correct.
Signature: ______Date: ______

______

______

Please Return Completed Application Form to Response Pastors (either post in or forward as attachment via email to:. Please indicate when/how payment was made.

Please tick if you wish to receive updates andcommunications about the work of Ascension Trust

by post □/by email□/by phone□/ by text□.

Response Pastor Training attended (date): or will be attended on:
Any additional information:

Response Pastor Application Form – Dec 20151 | Page