CAPERNWRAY HARBOUR Bible Centre

Support Staff Volunteer Application Form

P L E A S E P R I N T C L E A R L Y

 

POSITION SERVICE DATES What position are you applying for? Start Date: ...…………… Finish Date: ...……………

 PERSONAL INFORMATION Last Name First name Salutation Middle name Gender ❏ Male ❏ Female Date of Birth ………./day………./month………./year Home Street / Mailing Address City Prov / State Postal Code / Zip Country Telephone Cell Email Address Citizenship Country of Residence Passport No. Social Insurance No. (Canadian Residents only): Profession, Training, or Last Grade/Degree Completed

Outline previous work experience: How did you become aware of Capernwray Harbour?

EMERGENCY CONTACT For notification in the event of an emergency Name Relationship Contact Phone Number   T-SHIRT SIZE SM MED LG XLG  

OFFICE USE ONLY Date Received Passport Photo Admin. Initials & Comments

PHOTO (for recognition purposes)

Affix, enclose or email

1 PASSPORT SIZE PHOTO with application

(head & shoulder shot)

PRIVACY POLICY: Capernwray Harbour Bible Centre is committed to protecting the privacy, confidentiality and security of student, guest and staff personal information and has a Privacy Policy for these. The Policy can be found at our website www.capernwray.ca (under TAB “More Info”) or can be obtained by contacting us at 250-246-9440 (tel), 250-246-3201 (fax) or chbc@capernwray.ca.

 

   

     

  RELATIONSHIPS Which of the following applies to you? ❏ single ❏ engaged ❏ married ❏ widowed ❏ divorced ❏ single parent If engaged, do you have a date set for your wedding? If yes, when? If married, give name of spouse Do you have a friend or relative applying as well? If yes, please give their name(s) What is their relationship to you? HEALTH & MEDICAL INFORMATION If you answer ‘yes’ to any of the following questions, please provide details on a separate sheet to be enclosed with this application. *You may be required to provide a medical doctor’s report.

1. Do you suffer from any disability, which would limit you participating in practical duties? ❏ yes ❏ no 2. Have you had surgery within the past six months, or extended medical care? ❏ yes ❏ no 3. Do you have diabetes, epilepsy, blackouts or other diagnosed medical problems? ❏ yes ❏ no 4. Do you require any regularly prescribed medication? ❏ yes ❏ no 5. Do you have any allergies? ❏ yes ❏ no 6. Do you require a special diet for medical reasons? ❏ yes ❏ no 7. Do you have a learning disability? ❏ yes ❏ no 8. Have you had nervous or mental illness at any time (eg. depression, anxiety, panic attacks etc)? ❏ yes ❏ no 9. Have you suffered from or had treatment for anorexia nervosa or bulimia? ❏ yes ❏ no 10. Have you struggled with self-harm (eg. suicidal tendencies, cutting etc)? ❏ yes ❏ no 11. Have you used tobacco, alcohol or illegal drugs at any time in the last year? ❏ yes ❏ no 12. Have you ever had treatment for an addiction (eg. alcohol, drugs, sex, pornography, gaming)? ❏ yes ❏ no 13. Do you regularly or periodically view pornographic material? (found on the internet, in magazines, movies etc.)? ❏ yes ❏ no Name of current medical plan:

Medical Plan number (Canadians; please give Provincial Health Care Card Number): All volunteers are expected to provide their own medical coverage. An economical plan with adequate coverage is available through Capernwray Harbour Bible Centre for volunteers who do not have any medical coverage.

TALENTS, HOBBIES & WORK EXPERIENCE Do you have any specific abilities or experience that could be useful for the practical running of the Bible Centre? Eg. carpentry, plumbing, lifeguarding, wilderness skills training, certified cooking etc. What are your hobbies? Do you play a musical instrument? If so, which one(s). Have you any previous experience in outreach ministries involving singing, music or drama? If so, please detail.

In what Christian service have you been engaged? Give the name, address & pastor’s name of the church you are currently attending?

     

     

Have you been convicted of a crime requiring jail term, parole or probation? ❏ yes ❏ no If yes, please specify on lines below and answer the following question: Are you legally restricted from working near or in direct contact with children, youth, seniors or persons with disabilities? ❏ yes ❏ no If yes, please specify on lines below.

CHRISTIAN EXPERIENCE (use separate sheet and attach for longer answers to questions below) Give a brief account of your conversion and experience of the Lord Jesus Christ

How has the Lord been working in your life recently and how would you describe your relationship with Him today? What are your reasons for applying to serve at Capernwray Harbour Bible Centre as a Support Staff Volunteer? REFERENCES Please provide the names & addresses of those who will be filling out a reference form for you. • Pastor or Church Official Reference Name Email:

Address

• Friend or Associate Reference Name Email: Address

     

       

 

SUPPORT STAFF VOLUNTEER REQUIREMENTS & CONDITIONS OF ACCEPTANCE APPEARANCE • Clothing: Clean, neat and modest dress as worthy of a Christian who desires to glorify the Lord Jesus will be expected. Please show moderation and modesty at all times, regardless of prevailing fashions in a permissive society. • Church Attendance: Semi-dress attire will be expected when attending church meetings. No jeans or shorts to be worn. • Piercings: No facial or body piercing. No earrings on male volunteers. • Hair: Hair is expected to be clean, tidy & well groomed. No extreme styles or colours. SUPPORT STAFF VOLUNTEER CONDUCT, LIFESTYLE & ADDICTIONS • Support Staff Volunteers will give full cooperation to the staff & administration of Capernwray Harbour Bible Centre. • Support Staff Volunteers are not allowed in or around the volunteer accommodations of the other sex as these are considered bedroom areas. • A curfew for volunteers will be in place and expected to be adhered to in order that volunteers may get adequate rest and due to community living. • Volunteers are to abstain from promoting and engaging in premarital or extra marital sexual involvement, pornographic involvement and homosexual behaviour. • The use of tobacco (including e-cigarettes), alcoholic beverages and illegal drugs are strictly forbidden for legal, moral and spiritual reasons. It is expected that Support Staff Volunteers who indulge in these will quit prior to their time of service at Capernwray Harbour and abstain throughout the service dates and stay. Pubs & bars are considered inappropriate for Christian fellowship and are considered off limits for Support Staff Volunteers. • All Support Staff Volunteers are expected to provide their own medical coverage during the service period. • Support Staff Volunteers are expected to display a positive self concept in appearance, behaviour and friendships with others as well as a willingness to mature and grow as a Christian. Pursuing exclusive, serious companionship with the other sex will be discouraged during the service period. SERVICE OBLIGATIONS • Support Staff Volunteers are expected to complete the time of service applied & accepted for from start date to end date. • Support Staff Volunteers will be required to undergo a criminal record check and have the results submitted to Capernwray Harbour prior to their arrival. • All non-Canadian Support Staff Volunteers living temporarily in or outside of Canada will apply for the appropriate visa to allow them to serve in Canada as a religious volunteer ADDITIONAL INFORMATION & CONDITIONS OF ACCEPTANCE • Support Staff Volunteers are volunteers and as such will receive no remuneration, though living expenses will be generously provided for. Such things as room & Board, use of laundry facilities as well as other amenities will be provided throughout the duration of a volunteer’s term of service. • Please read and sign below if in agreement with the above Support Staff Volunteer requirements, Conditions of Acceptance and the following statement: I am willing to participate in the ministry of Capernwray Harbour Bible Centre as a volunteer. I will endeavor to fully cooperate with the leadership of Capernwray Harbour. I will seek every opportunity for personal spiritual growth and to serve the Lord Jesus through living, verbal witness. I have considered this matter prayerfully.

Printed name of applicant Signature of Applicant Date

APPLICATION INFORMATION CHECKLIST All applicants, please CHECK the following: ❏ I have answered all questions in this application form ❏ I have enclosed the following item with this application form:

• One passport-size photo, head & shoulders shot ❏ I have read through the ‘Requirement & Conditions of Acceptance’ & signed the ‘Conditions of Acceptance’ above ❏ I will give one reference form to my minister and one to a non-relative who knows me well to fill out & return ❏ I will mail this completed application form with required enclosures to:

Personnel Manager Capernwray Harbour Bible Centre PO Box 1-10 Thetis Island BC V0R 2Y0 Canada

❏ I will undergo a criminal record check and have the results submitted to Capernwray Harbour prior to arrival ❏ I will apply for the appropriate visa to come to Canada and serve as a religious volunteer if I am a non- Canadian living temporarily in or outside of Canada

SUPPORT STAFF VOLUNTEER REFERENCE FORM

P L E A S E P R I N T C L E A R L Y

INSTRUCTIONS TO APPLICANT: Fill out your name and address below and give one form to your minister and one to an adult, who is not a relative, who knows you well.

Last Name First Name Address City Prov / State Country REFERENCE: The applicant named above has indicated your willingness to be a reference for their Support Staff Volunteer application. We would appreciate you answering the following questions. Length of relationship with applicant is:

……….less than 1 yr ……….1 – 2 yrs ………3 – 5 yrs ……….+ 5 yrs How well do you know the applicant?

……….by name/sight ……….casually ……….fairly well ……….very close How long has the applicant been a born-again Christian? Please indicate the level of consistency in each of the following areas of the applicant’s life: Consistent Frequent Occasional Seldom Bible Study …………… …………… …………… …………… Church Attendance …………… …………… …………… …………… Church Service & Ministry …………… …………… …………… …………… Witnessing …………… …………… …………… …………… Challenging others spiritually …………… …………… …………… …………… Is the applicant mature enough to adjust & live in a Christian Community setting?

……….strongly agree ……….agree ……….disagree Does the applicant use or indulge in the following:

……….tobacco ……….alcohol ………. illicit drugs ……….none to my knowledge I believe the applicant shows particular ability in: I have no reservations concerning the applicant’s honesty & integrity:

……….strongly agree ……….agree ……….disagree I recommend the applicant for service at a Torchbearer Centre:

……….unreservedly ………. with reservations ……….do not recommend

If you do not recommend, please comment:

 

To your knowledge, has the applicant ever been involved in the occult? ……….yes ……….no

In order to give us a better profile of the applicant as a person, please rate the applicant in each of the following by circling the number which best represents where the applicant fits on the scale: Self control 1 2 3 4 5 6 7 8 9 10 ? very little extremely self-controlled Committed Believer 1 2 3 4 5 6 7 8 9 10 ? uncommitted highly committed Teachable 1 2 3 4 5 6 7 8 9 10 ? rebellious supportive Home Background 1 2 3 4 5 6 7 8 9 10 ? unsupportive supportive Personality 1 2 3 4 5 6 7 8 9 10 ? withdrawn outgoing Relationships 1 2 3 4 5 6 7 8 9 10 ? abrasive congenial Emotional Stability 1 2 3 4 5 6 7 8 9 10 ? unstable stable Initiative 1 2 3 4 5 6 7 8 9 10 ? never initiates takes initiative Leadership 1 2 3 4 5 6 7 8 9 10 ? never leads leader Dependability 1 2 3 4 5 6 7 8 9 10 ? irresponsible extremely dependable Judgement 1 2 3 4 5 6 7 8 9 10 ? poor very discerning Please add any further comments you feel would be helpful regarding the applicant: Name of Reference Position Address City Prov / State Postal Code / Zip Country Telephone Reference Signature Date Please return the completed form to: Capernwray Harbour Bible Centre, PO Box 1-10, Thetis Island BC V0R 2Y0 Canada, Phone: (250) 246-9440, Fax: (250) 246-3201

PRIVACY POLICY: Capernwray Harbour Bible Centre is committed to protecting the privacy, confidentiality and security of student, guest and staff personal information and has a Privacy Policy for these. The Policy can be found at our website www.capernwray.ca (under TAB “More Info”) or can be obtained by contacting our Privacy Officer at 250-246-9440 (tel), 250-246-3201 (fax) or dsnyder@capernwray.ca.