Sample declaration form for prospective lay workers
Affirmations and acknowledgements
Working for the Christian church places a person in a position of trust. As part of your application you are required to make the following affirmations and give consents.
1. If appointed I will accept the authority and discipline of the Presbyterian Church of Aotearoa New Zealand, as exercised through the Presbytery within whose bounds I work, and will uphold the polity, teaching and doctrine of the Presbyterian Church of Aotearoa New Zealand while I hold the position.
2. I have/have not been convicted of any criminal offence involving violence or sexual abuse.
Comment: ________________________________________________________________________
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3. I have/have not been disciplined by any church for any unethical or unprofessional behaviour.
Comment: ________________________________________________________________________
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4. I consent to the Presbyterian Church seeking verbal or written information about me from the referees whose names I have supplied and from representatives of employing bodies with whom I have worked and authorise the information sought to be released. (The applicant will be advised of any approaches made to any such referees/representatives who have not been named in this application form before any approach is made.)
5. I consent to the Presbyterian Church undertaking a police check here in New Zealand and in any country where I have lived/worked.
To the best of my knowledge the statements given are correct and I understand that if any false or misleading information is given or material fact suppressed my application will not be processed or if appointment my appointment may be terminated.