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Application Form
Application Form
Application for Chaplain ACCESS ministries
(168Kb)
Chaplain Application Form
** Important Note before you start: Please ensure that you have gone through and completed all the SECTIONS ABOVE first before clicking on the SUBMIT button. Clicking on the Submit button before you have completed the entire application will result in your application being sent off to us prematurely. So, please
only
click the SUBMIT button right at the end of the application process under the Sign Off page.
Personal Information
We recommend completing and returning the attached Word Document as your application. Alternately complete all tabs of the online form. This form must be completed before you can apply for endorsement as an ACCESS ministries chaplain in a Victorian School.
Note: Please keep a record of your email address and password as this is required should you wish to save the application prior to completion.
Privacy Statement The information you submit will only be used by ACCESS ministries for the purpose of assessing your suitability as a candidate for Chaplaincy.
Fields marked with a asterisk (*) are required.
Title:
Mr
Mrs
Miss
Ms
Dr
Prof
Assoc Prof
Capt Mrs
Captain
Colonel
Maj Mrs
Major
Pastor
Rev
Sister
Revd
The Revd
The Revd Canon
The Revd Dr
The Revd Fr
The Ven Dr
The Very Revd
* First Name:
* Last Name:
* Email Address:
Home Phone:
Business Phone:
Mobile:
* Postal Address:
* Suburb:
* State:
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Other
* Postcode:
Select Other if outside Australia
* Country:
Australia
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegowina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
France, Metropolitan
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-bissau
Guyana
Haiti
Heard and Mc Donald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia (Slovak Republic)
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Pierre and Miquelon
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City State (Holy See)
Venezuela
Viet Nam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
Other
I am an Australian Citizen
I have Permanent Residency in Australia
Church Membership
* Denomination:
* I Currently Attend Church at :
* I am an ordained minister:
Yes
No
Education
As Chaplains need to stand alongside the teaching staff, the minimum requirement for an ACCESS ministries school chaplain is a degree in either theology, education or counseling with experience or study in the other areas not covered by the degree. (We are happy to provide assistance with selecting an appropriate course of study, please contact chaplaincy@accessministries.org.au)
Fields marked with a asterisk (*) are required.
* Educational Institution/College/University:
* State:
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
NZ
Other
* Educational Level Achieved:
* Year:
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
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1977
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1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
* Type of Study :
Secondary/Tertiary
Ministerial/Theological
Teacher Training
Other
Additional Education
* Educational Institution/College/University:
* State:
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
NZ
Other
* Education Level Achieved:
* Year:
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
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1959
1958
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1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
* Type of Study:
Secondary/Tertiary
Ministerial/Theological
Teacher Training
Other
Add other qualifications/courses. Please upload in .doc format and include ALL study completed.
Experience
Fields marked with a asterisk (*) are required.
Position Held:
Location:
Start Year:
End Year:
Position Hours:
Full Time
Part Time
Casual
Employment Type:
Previous Employment
Ministry Experience
Teaching Experience
Other Relevant Experience
Present Employment
Add another previous employment (please upload ALL relevant experience):
Faith Development
In the form below, please outline in point form, the significant developments in your faith journey and your calling to chaplaincy. Please include the special qualities you bring to chaplaincy.
Fields marked with a asterisk (*) are required.
* Note: Please write as much as you would like, space is not limited to the size of the box
Reflections upon yourself as a Chaplain
Please comment on the following aspects concerning a Chaplain with reference to yourself
Note: Please write as much as possible, space is not limited to the size of the box.
Fields marked with a asterisk (*) are required.
* 1. A Christian who lives out a personal relationship with God, is a participating member of a congregation and is in good standing with their denomination:
* 2. A person who affirms the basic tenants of ACCESS ministries as an ecumenical Christian organisation as outlined in the ACCESS ministries Core Values booklet:
View
ACCESS ministries Core Values booklet
* 3. Having a sense of calling to chaplaincy as a Christian ministry:
* 4. Is self-aware and has an empathy with others:
* 5. Has an ability to work in a team as well as independently:
* 6. Has a commitment to learning:
References
Please submit details of at least three professional persons from whom enquiries can be made as to your suitability for School Chaplaincy. These names should include a minister from your church, at least one person actively engaged in education in State School and another actively involved in pastoral or specialist ministry, and at least one referee from a recent employer.
Fields marked with a asterisk (*) are required.
Reference 1
* Title:
Rev
Mr
Mrs
Miss
Ms
* First Name:
* Last Name:
* Email:
* Phone:
Address:
* Position:
Reference 2
* Title:
Rev
Mr
Mrs
Miss
Ms
* First Name:
* Last Name:
* Email:
* Phone:
Address:
* Position:
Reference 3
* Title:
Rev
Mr
Mrs
Miss
Ms
* First Name:
* Last Name:
* Email:
* Phone:
Address:
* Position:
Add another referee (please upload):
Self Assessment and Comparison
In this section you are required to self assess and compare to the ACCESS ministries expectations for the Key Capability Matrix for the task of Chaplain.
Read the
ACCESS ministries Capability Matrix for Chaplains
and select your self assessment (level number) from the choices below
Fields marked with a asterisk (*) are required.
* Theology & Ecumenism:
1
2
3
4
5
* Religious Education:
1
2
3
4
5
* Pastoral Care:
1
2
3
4
5
* Counselling:
1
2
3
4
5
* Leadership:
1
2
3
4
5
* IT & Communication:
1
2
3
4
5
* Community Development:
1
2
3
4
5
* Record Keeping:
1
2
3
4
5
* Public Relations:
1
2
3
4
5
* Financial Management:
1
2
3
4
5
Availability
Fields marked with a asterisk (*) are required.
* If accepted, when will you be available for appointment as a chaplain?:
* My Preference for location is:
Metropolitan Melbourne
Country
* My School preference is:
Primary
Secondary
Primary/Secondary
Sign Off
I have read the following documents
*
ACCESS Core Values
*
I acknowledge that all the information I have entered is correct.