APPLICATION FORM –Youth ACADEMY 2017
The information you supply will be used by Warwickshire Police to assess your suitability to participate in the 2017YouthAcademy at a venue in Warwickshireon the 14thand 15th October2017.
Title / - select - MrMrsMissMsOther
Surname/family name
First name
Current address
Postcode / Nationality
Date of birth / Age
Email address
Home phone number
Mobile phone number
School / School year / - Select - Year 9year 10year 11year 12

Please provide contact details of a parent/guardian who has given permission for you to attend and can act as a contact in case of emergencies

Title / Mr/Mrs/Ms/Miss/Other (Delete as appropriate) - Select - MrMrsMissMsOther
Surname/family name
First name
Relationship to applicant
Email address
Home phone number
Mobile phone number
Daytime phone number
Warwickshire Police welcomes applications from people with disabilities and from all backgrounds. We will ensure that reasonable adjustments are made wherever necessary to facilitate your participation. There maybe circumstances where we will need to make a follow up call to discuss anything highlighted below.
Do you have a disability, health issue or special requirement that we should be aware of?
- Select -YesNo
If Yes - please provide details below / Do you take any prescribed medication for any reason?
- Select-YesNo
If Yes - please detail below
Are you suffering from any illness
- Select -YesNo
If Yes - please provide details below
How did you hear about the YouthAcademy (place X in relevant box)
School / School PCSO / Facebook / Twitter / Police Website / Other
Declaration
I declare that all the information provided on this application form is true and complete to the best of my knowledge and belief, and that no relevant information has been withheld.
I agree to notify changes or additions in the information I have provided on this form.
I understand that if I have knowingly made a false statement or deliberate omission in the information I have provided on this form, my application to the YouthAcademy will be terminated.
I give my permission for Warwickshire Police to use the data I have supplied on this form for the purpose of security checks and vetting – in relation to this application.
I commit to attend the full 2 days, subject to unforeseen circumstances preventing my attendance.
Signature(young person)
Signature
(appropriate adult, please include relationship to young person) / Date
Data Protection Act 1998
The information you have supplied is governed by the Data Protection Act 1998 and will be used for the purpose of administering this application.
Youth Academy – Photo Consent Form
Parental / Guardian Consent

I (name) give my permission for photographs and/or video footage to be

taken of (name)

by Warwickshire Police and other agencies taking part of The Youth Academy activities.

I understand that the photos and footage maybe be used by Warwickshire Police and also by the other agencies taking part on websites, social media or other promotional material.

No names or personal details will be used of any young person with any photos or footage without additional consent .

Signed
Full Name
Relationship to young person