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Young Life Gap Year Background Check Form

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Part of our legal obligation is to ask you the following questions.

Name
Please provide us with the name of the town / suburb / are you are applying to embrace Gap Year with.

Background Check Questionnaire

Please answer "yes" or "no" to the following questions. If you answer "yes" to any question below, we ask that you provide a complete explanation of the circumstances. If you feel there are any extenuating circumstances, such as your age at the time, please provide that information.

• Have you ever been convicted of a criminal offence (except for minor traffic violations)? You will need to answer "yes" if you have entered into a plea agreement, including a deferred sentence or deferred judgment arrangement, in connection with a criminal charge.
• Have you ever been charged with a sexual offence, crime of violence or offence relating to children?
• Have you ever been reported by a social services agency, law enforcement authority, child abuse registry or similar organisation regarding abuse or misconduct involving children?
• Have you ever been subjected to expulsion, reprimand, or other discipline by a church, denomination or other religious organisation, including Young Life Australia?
• Have you ever been dismissed from employment by any employer, including Young Life Australia and/or other charitable and religious organisations, following an allegation of sexual misconduct or other immoral or inappropriate behaviour or conduct?
• Have you ever been the subject of an investigation, or allegation of sexual misconduct, sexual harassment or other immoral behaviour or conduct involving adults or children?

Young Life Australia will evaluate what you have written, and may ask you to provide additional information. In addition, Young Life Australia may determine that it needs to conduct an investigation and may require your assistance with this. While indicating "yes" to any of the questions above will not result in automatic disqualification or termination from the Young Life Australia Gap Year program, Young Life Australia may determine that an affirmative response would make an individual unfit for service or association with Young Life Australia's ministry. In all cases, Young Life Australia reserves the right to determine, at its discretion, what action should be taken. If any of your responses or information provided on this form are untruthful or inaccurate, Young Life Australia may determine that you are no longer qualified to be associated with the ministry in any capacity.

Personal Background

Due to the nature of our ministry, it is important that our gappies join us in making a personal commitment to Young Life's Christian purpose. Please answer the following questions to help us in evaluating where you might best use your gifts and talents.
Please note: having no experience does not exclude you from joining our program.
Please note: having no experience does not exclude you from joining our program.

Reference Contact Details

From the following list, choose two for which we may contact to do a further background check: Pastoral / Spiritual Leader | Young Life Staff Worker | Ministry Co-Worker | Employment Supervisor / Boss. One must be your regular church minister.
Referee 1 - Name
Referee 2 - Name
If you would like to provide any further details of referees or references, please do so above.

Acknowledgement

Gappie Statement

I authorize, at Young Life Australia's discretion, investigation of all statements made by me in this application, and review of any civil or criminal records, which may exist, concerning me, except for such records as are sealed according to State or Commonwealth law. I further authorize Young Life Australia, at its discretion, to contact employers, references and others whose names are provided on this application form, or whose names may be identified by me in an interview, and I authorize such persons to provide Young Life Australia with information requested by Young Life Australia regarding me. I further release any such individuals, as well as Young Life Australia, from any claims I might have arising out of any discussions involving me, or the provision of any information or records regarding me. I understand that I am serving at all times on a program without expectation of compensation and not as an employee of Young Life Australia. In the event I become a gappie with Young Life Australia, I understand that false or misleading information given in my application or interviews may result in dismissal.

Gappie Statement