• 1.Introduction

    Coleraine Street Pastors requires all volunteers to:
    A. Be a professing Christian;
    B. Be over 18 years of age;
    C. Be committed to a local church in fellowship with the wider Christian community in the area;
    D. Have a positive reference from the leader of that church confirming that they would be suitable to be a Street Pastor and that they are currently leading a Christian lifestyle.

  • 2. Important Information

    Read all the information before you complete this application.
    Type or write neatly in BLACK INK, as this form will be photocopied.
    We want to ensure that the recruitment process is equally accessible to applicants with disabilities. So if you would like us to make any arrangements in this respect, please let us know.
    Please continue your answers on a separate sheet if you need to.

  • 3.Personal Details
  • Date Format: MM slash DD slash YYYY
  • For office use only
  • 4.Church Details
  • 5.Christian History
  • 6.Your Skills
  • 7.Your Health
  • 8.Emergency Contact 1

    Please give the name, address and telephone number of two persons who we may contact in case of emergency.

  • 8.Emergency Contact 2

    Please give the name, address and telephone number of two persons who we may contact in case of emergency.

  • 9.References

    Two referees are required: One must be a Pastor or home group leader and the second a person of your choice. Please state their name and address:

  • Reference 1
  • Reference 2
  • Declaration:

    I confirm that to the best of my knowledge the information given in this application form is true and correct.

  • Under the terms of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975, the persons you will be working with include children and vulnerable adults. This means that you are exempt from the Act and will be asked to declare any previous criminal convictions including ‘spent’ convictions. This information can then be used as a basis for deciding whether or not you are suitable to work with children and vulnerable adults. The disclosure of an offence will not necessarily be a bar to your appointment. However, failure to disclose an offence or other misrepresentations may result in the termination of your services. This form is strictly confidential and, except under compulsion of law, will be seen only by those responsible for your appointment, the Coleraine Street Pastors Child Protection and Vulnerable Adults Officer and his/her deputy. All forms will be kept securely under the terms of the Data Protection Act 1998.

    Please refer to the Guidance Notes when completing this form. If you answer YES to any question, please give details, using a separate sheet if necessary, giving the number of the question you are answering.
  • Please tick either the YES or NO Box in answer to EVERY QUESTION
    If yes, please give details, including the date(s) and nature of the conduct, or alleged conduct, and whether you were dismissed, disciplined, moved to other work or resigned from any paid or voluntary work as a result.
  • Before an appointment can be confirmed, applicants must ensure that they have applied for an Enhanced Disclosure Without Barred List Check from the Disclosure and Barring Service.