Restricted Staff (When Completed)

Restricted Staff (When Completed)

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• The information you provide in this questionnaire will be treated in the strictest confidence. It is in your interest to make a full and frank disclosure.

• You should complete all sections of this form personally and in black ink if you plan to send it to us by post. If you are completing an electronic version of this form, complete the grey shaded fields, save the document and email it to the address provided. Check that you have completed ALL the questions by ticking responses as appropriate, or by providing an answer in the spaces below. Where a question is not applicable or the answer is not known or not easily obtainable, enter Not Applicable (N/A) or Not Known (N/K) respectively. Please note that N/A or N/K responses may cause delay to your clearance. Should you require extra space to answer questions please insert a sheet of A4 in postal applications. Please put your full name at the top of each continuation sheet.

Remember to complete the declaration on Page 5 and 8

SECTION 1

Personal Details
Surname / Surname at Birth (if different)
Forename(s) / Title
Mr Miss
Mrs Dr
Ms / Any other name(s) you are known by/have used previously
Place and Country of Birth
Current Address
Postcode / Date of Occupancy
Month Year / Is address multi-occupancy?
Yes No
Contact numbers / Home
Mobile / Work (if convenient)
Email address
National Insurance No

VETTING INFORMATION

Previous Addresses

Please give all addresses at which you have lived over the last five years. Start with the most recent. Do not include your current address. Continue on a separate sheet if necessary.

Full Address
(include postcode if known) / Approximate dates
from (month/year) to (month/year)
1. / From
To
Multi-Occupancy: Yes No
2. / From
To
Multi-Occupancy: Yes No
3. / From
To
Multi-Occupancy: Yes No
About your family

Please tell us about your family (wherever they live), and any other adults living at your address.Please include maiden namesand details of any deceased members of your family. Continue on a separate sheet if necessary. Please complete all sections or your application will be delayed.

Relationship to you
(delete as appropriate) / Full Name
(include previous surnames and maiden names and name at birth if different) / Full Address
(including postcode if known)
Yourself
Date and place of birth
Your Spouse/Partner
Date and place of birth
Your Father
Date and place of birth
Your Stepfather or Mother’s partner
Date and place of birth
Your Mother
Date and place of birth
Your Stepmother or Father’s partner
Date and place of birth
Your Brother or Sister
(Full/half/step etc)
Date and place of birth
Your Brother or Sister
(Full/half/step etc)
Date and place of birth
Your Spouse’s or Partner’s Mother/ Stepmother etc
Date and place of birth
Your Spouse’s or Partner’s Father/ Stepfather etc
Date and place of birth
Your Child/ Child of Partner
(only state if aged 10+)
Date and place of birth
Your Child/ Child of Partner
(only state if aged 10+)
Date and place of birth
Your Child/ Child of Partner
(only state if aged 10+)
Date and place of birth
Your Child/ Child of Partner
(only state if aged 10+)
Date and place of birth
Other adults living at your address (e.g. lodger)
Date and place of birth

As part of the vetting process applicants should advise all relevant family members –your spouse/partner, co-habitee, parents, brothers, sisters and step relatives, that their details have been included in the questionnaire.

Convictions and Cautions
Have you been convicted for any offence or had any formal cautions/reprimand by Police (including Military Police) for any offence or kind of bind-over imposed by any court? (include traffic convictions; other fixed penalty notices e.g. public order, drunkenness and appearances before a court martial and any cautions as a juvenile)
Yes No
If you have answered ‘Yes’, please enter details below
Date
(most recent first) / Offence/
Alleged Offence / Result
(if known) / Court/Police Station involved
Do you have any impending prosecutions? Yes No
If ‘Yes’ please provide details as above
Have you ever been involved in a criminal investigation or been arrested (whether or not this led to any prosecution to yourself or others) or been associated with criminals?
Yes No
If ‘Yes’, please give details.
Additional Information
Is there anything that you think you ought to bring to the attention of the Police Service concerning your past, your integrity, your associations? This includes working in the media as an investigative journalist, media researcher or other media related activity. When in doubt, please include.
Declaration
I consent to the information contained in this application form being submitted for checking against the records of the Police and Credit Reference Agencies. I understand that the information I have provided will be treated in the strictest confidence.
I confirm that my spouse/partner has been informed that his/her details have been provided as part of the vetting process.
I declare that the information I have provided is true and complete to the best of my knowledge and belief.
I undertake to notify any significant changes or additions in the information I have provided in this form.
I understand that if I have knowingly made a false statement or deliberate omission in the information I have provided in this form, my application may be rejected.
Signature of Applicant Date
For electronic applications please type name for signature
Volunteers from overseas
Yes No
Do you require a permit to volunteer in this country?
See relevant section in guidance notes.

If ‘Yes’ do you have a current permit?

If ‘Yes’ please indicate expiry date
Have you lived in the UK for the past 3 years?

SECTION 2

Tattoos and Piercings
Yes No

Do you have any tattoos on your hands, neck, forearms

or face?
If ‘Yes’ please describe their nature and location.
What level of commitment can you offer?
Approximately how many hours a week can you volunteer?
2 4 / 6 / 8 / Other
(Please State)
The cadets currently meet on Wednesday evenings. However, as you may be invited to take part in events on other days, please indicate below any other days on which you will be available.
Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday
Please indicate what time of day is most convenient?
9am to 12 noon / 12 noon to 5pm / Evenings
Base Preference: which base would you prefer to volunteer at?
Please choose from the list below:
Clifton
Gedling
Mansfield
Newark

Section 3

Current Employment
Please give details of your current employment
Previous Employment
Please give details of your previous employment
Skills and Experience
Yes No
Do you hold a current driving licence?
Do you have access to private transport?
Do you hold a First Aid Certificate?
Can you speak any other languages in addition to English?
If ‘Yes’ please state:
Can you either:

• Use British Standard Sign Language?

• Read Braille?

Why would you like to become a cadet leader?
Do you have any skills or experiences which may help you in your role as a cadet leader? (not essential)
How did you hear about the Nottinghamshire Police Cadet Leader Role?
References
Please give the names and full addresses of two people, not relatives, who have known you for a minimum of two years who are prepared to vouch for your character and recommend your application.
Reference 1 / Reference 2
Name / Name
Address / Address
Postcode / Postcode
Telephone Number(s) / Telephone Number(s)
Email / Email
How long have you known him/her? / How long have you known him/her?
Declaration
I hereby declare that the information I have given in this application is true to the best of my knowledge and belief and that I have not knowingly withheld any relevant information. For electronic applications please type name for signature.
Signature of Applicant / Print Name
/ Date

Please send completed forms to:

Volunteer Coordinator

Nottinghamshire Police

Sherwood Lodge

Arnold

Nottingham

NG5 8PP

Or email to:

Please note that to meet the security vetting criteria; you will need to bring to 2 forms of ID to your interview. One must be photographic and the other a recent official document showing your current address.

EQUAL OPPORTUNITIES MONITORING FORM

Name: Title: Dr Mr Mrs MsMiss

VOLUNTEER SERVICES TEAM

Policy Statement

Policy statement

Nottinghamshire Police is committed to providing equality of opportunity in terms of employment. The Policy

Statement applies to all staff and applicants regardless of race, gender, marital status, colour, nationality, religion or belief, ethnic or national origin, sexual orientation, age or disability. This commitment applies to all issues affecting recruitment, training, transfer and promotion including terms and conditions of service.

To assist us in assessing the effectiveness of this policy and only for this reason, please complete the following details. This information will NOT be used in deciding your suitability for the post.

Date of Birth:

Age 16-25 26-35 36-45 46-55 56 & over

Gender Male Female Other

Disability Yes No

Ethnic Origin Sexual Orientation

White / British / Bisexual
Irish / Gay
Any other white background / Heterosexual
Mixed / White and Black Caribbean / Prefer not to say
White and Black African
White and Asian /

Religious Belief/Faith

Any other mixed background
Asian or Asian / Indian / Buddhist
British / Pakistani / Christian (state
Bangladeshi / denomination if you
Any other Asian background / wish)
Black or Black British / Caribbean / Hindu
African / Jewish
Any other black background / Muslim
Chinese or other ethnic group / Chinese / Sikh
Any other (please specify) / None
Other (Please state)

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