Clergy and Educator Abuse Survivors Empowered! |
Prevention |
SDA Leaders Designate August
31, 2002
Abuse Prevention Awareness Day
On September 26, 2001, members of the General Conference Executive Committee voted, by an action of the Annual Council, to designate the fourth Sabbath of August 2002 as Abuse Prevention Emphasis Day. break the silence. More info...
Sample policies and procedures for preventing and addressing child abuse and sexual misconduct -- one conferences approach.
(The following materials were prepared by the Southeastern California Conference of Seventh Day Adventists and are reproduced here with permission. These materials are to be used as samples only and do not represent legal advice in any form.)
For Volunteer Workers with Children and Youth
The congregation and staff of the _________________ Church are committed to providing a safe environment to help children learn to love and follow Jesus Christ. At this time, the disturbing and traumatic rise and recognition of physical and sexual abuse of children has claimed the attention of our nation, our society and this church. Churches with programs for children are not insulated from those who abuse.
Therefore, the ________________ Church believe that it is vitally important to take decisive steps to ensure that the church and its programs are safe and provide a joyful experience for children and youth. The following policies have been established and reflect our commitment to provide protective care of all children when they are attending any church sponsored programs or activities.
Southeastern California Conference Application for Children and Youth Volunteer Worker Position |
_______________________________________________
(Name of Church)
Name | _____________________________ | |||
Address | _____________________________ | |||
City | _____________________________ | State | ____ | |
Telephone | Home (___) ________ Work (___) ________ | |||
Social Security # | ________________________ | Other Licenses | _____________________ | |
Drivers License | ________________________ | Expiration Date | __________________ |
What type of childrens or youth work do you prefer?
________________________________
(Sabbath School teacher, VBS teacher, childrens music program, nursery,
coordinator, etc.)
What time commitment can you make? ________________________________________
Are you a member of the Seventh-day Adventist Church? Yes__ No __
How long? _________ How long in this congregation? ________
Where have you attended church in the past five years? ________
What previous work have you done with youth and children? What are
your gifts in this kind of work?
____________________________________________________________________
What training have you had for work with children? ____________________________
____________________________________________________________________
What non-church activities have you done involving children? __________________
____________________________________________________________________
List names of other members of this congregation with whom you have a relationship.
____________________________________________________________________
Were you ever the victim of abuse or sexual molestation as a child?
Yes__ No__
(You may refuse to answer this question or may discuss your answer in confidence
with the pastor rather than answering on this form. Answering yes, or leaving the question
unanswered will not automatically disqualify an applicant for work with youth or
children.)
Have you ever been accused of sexual misconduct with a minor? Yes__ No__
Do you have any disability that will impair your work with children? _________________
Education:
Name of High School/ Academy __________________ Degree/Diploma Yes__ No__
Name of College __________________ Degree/Diploma Yes__ No__
Where are you currently employed? ___________________ Position
______________
Work Address ______________________________________________________
Previous employment (five years past to current)
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Please list two references which are not former employers or relatives who know of your work with minors.
Name _________________________________ Telephone (___)__________
Address ____________________________________________________________
Name _________________________________ Telephone (___)__________
Address ____________________________________________________________
The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give any information that they may have regarding my character and fitness for working with children or youth. I hereby release any individual, church, or organization from any and all liability for damages which may result to me, my heirs, or family for compliance with this authorization.
Your signature on this form confirms your understanding and agreement that:
In the event allegations of criminal or sexual misconduct arise regarding your conduct while you serve in the above-described capacity (ies), the church will fully cooperate with any investigation.
I further state that I have carefully read the foregoing release and understand the contents thereof and I sign this release as my own free act. This is a legally binding agreement with I have read and understand.
_______________________ | ___________ |
Applicants signature | Date |
The following questions may be helpful in evaluating the appropriateness of volunteers who will work with children at your church. The comments with follow each question provide reasons for the type of questions used.
1. How long have you lived in this community?
2. Why do you want to work with (Pathfinders-Youth-Childrens Church-Childrens Sabbath School)?
3. Would your experience as a child have an impact on your working with children in this position?
4. How would your current relationships with family and friends impact your work with children in this position?
5. Have you had personal experience with child abuse? (Verbal, sexual physical, religious, emotional)
6. Has an issue or suspicion ever been raised that you may have abused or molested or touched a child inappropriately? How was it resolved?
The following guidelines are provided to create an awareness of vulnerability to civil and criminal liability as well as to instill the need to protect children.
(for all workers with children and youth)
_______________________________________________________________________
(Name and Address of Local Church)
_______________________________________________________________________
Name of Volunteer __________________________ Request Date ___________
Reference Name ______________________ Telephone (___) ___________
Address _______________________________________________
The _______________________ Seventh-day Adventist Church is committed to providing a safe environment where children and youth may learn to love and follow Jesus Christ. The person named above has volunteered to work with children and/or youth and has given your name as a reference along with a release statement which appears on the reverse side of this page. We ask for your comments and opinions regarding the suitability of this person as a worker with children or youth. Please return this form in the enclosed self-addressed envelope. You may also call the pastor at ______________________
Thank you for your prompt attention to this request.
______________________________________________________________________
What is your relationship with the named volunteer?
__Friend | __Relative | __Co-worker | __Employer |
__Church representative | __Pastor | __Other |
How long have you known this person? _____
Describe what kind of contact this person has had with children or youth. (i.e. parent, youth worker, teacher, etc.)
Have you been able to make direct observations of this person actually working with children or youth?
__Yes __No
If yes, please summarize briefly your observations.
Do you know of any reason why this person would NOT be suitable for work with children or youth?
__Yes __No
If YES, please explain and include facts and names of other persons who can confirm these facts.
Do you have any reservations about recommending this person for work with children and youth and prefer not to provide further information?
__Yes __No
If no, please state your recommendation.
Signature_______________________ Date___________
(Photocopy of release statement below)
................................................................................................................................
For office use only
In the event of any allegations of child sexual abuse at church or on church related functions, the following response plan should be implemented immediately.
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