Future Builders Application Form

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Future Builders Application Form Powered By Docstoc
					                                       Future Builders
                                      Application Form

  Please return completed forms to: Dave Gidney, Future Builders, 1 Simms Lane, Hollywood,
                  Birmingham. B47 5HN Email office@future-builders.co.uk
1: Personal Details

Name_______________________________________________________________________

Address _____________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Postcode_____________         How long have you lived at this address? ____________________

If you have lived at the above address for less than 12 months please give your previous
address. ____________________________________________________________________
____________________________________________________________________________

Marital Status ________________________________________________________________

Tel. No. Day _____________________ Tel. No. Evening ______________________________

E-mail _________________________________________Date of Birth ___________________

Present Occupation____________________________________________________________

Previous Occupation(s)_________________________________________________________

Please list any educational qualifications you have____________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Please list any qualifications or experience you have in working with children.______________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Please give the name, address & telephone number of your next of kin____________________
____________________________________________________________________________

                    Supporting and encouraging excellence in children's work
                                Registered charity No. 284006
Please give the name & address of the church you attend, and the Minister’s/leader’s name
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

Are they aware of your application to us? ___________________________________________

2: Working with children

What experience have you had working with Children Worldwide or Whizz Kids? ___________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

In what ways do you feel gifted to work with children? ________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Are you currently registered to work with children under the 1989 Children Act? ____________

3: Christian Belief

Please briefly state your views about:

What is a Christian? ___________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Child Evangelism______________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

The Bible____________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

The person of Jesus ___________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

The Holy Spirit________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________




                    Supporting and encouraging excellence in children's work
                                Registered charity No. 284006
4: Medical Information

Do you have any medical conditions for which you are receiving treatment, or dietary
restrictions? __________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Have you experienced any nervous, mental or emotional disorders? _____________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

5. Declaration
You will understand the great responsibility involved in working with children and young people
and the need to ensure their safety.
You are therefore asked to read and sign the following declaration:
Have you ever been convicted of a criminal offence or been cautioned by the police or bound
over to keep the peace?        Yes / No.
Have you ever been held liable by a court for a civil wrong or had an order made against you by
a matrimonial or family court?          Yes / No.
Has your conduct ever caused or been likely to cause harm to a child or put a child at risk, or
have these things ever been alleged? Yes / No.
(This question is asking whether you have ever been the subject of an official investigation into
allegations of child abuse).
If the answer to any of these questions is 'Yes', please indicate what was the nature of the
offence or allegation on a separate sheet of paper attached to this form.
All convictions must be disclosed, as the provision of the Rehabilitation of Offenders Act 1974
does not apply.
This declaration is used by many organisations and churches and is in accordance with Central
Government Recommendations in the publication Safe from Harm.




                    Supporting and encouraging excellence in children's work
                                Registered charity No. 284006
6. Referees

Please provide details of you referees. References may be returned with your application, or
separately. Pass on the enclosed reference forms to your referees to complete them and
forward them to Dave Gidney.

Referee 1                                             Referee 2

Name ___________________________                               Name

Address __________________________                             Address _________________________
_________________________________                              ________________________________
_________________________________                              ________________________________
_________________________________                              ________________________________

Post Code ________________________                             Postcode ________________________

Tel. No. __________________________                            Tel. No. _________________________

Occupation _______________________                             Occupation ______________________


In what capacity do you know the referees you have given, and for how long? ______________
____________________________________________________________________________
____________________________________________________________________________

7. Personal Declaration

To the best of my knowledge, the information I have given on this form is current and accurate


Signed ______________________________________ Date _________________________




                    Supporting and encouraging excellence in children's work
                                Registered charity No. 284006