PROTECT - PERSONAL (When Completed)

PROTECT - PERSONAL (when completed)

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Candidate URN:
Office Use Only
Candidate URN:
Tier 2:
Tier 3:

Police Support Volunteer

Application Form

You should refer to the following documents before completion:

the Application Guidance Notes;
Advert/Task Profile.

The following documents must be completed in full in BLOCK CAPITALS before you can be considered for a role as a Police Support Volunteer:

Candidate Profile;
Vetting Form (when required);
Medical Questionnaire (when required);
the Equal Opportunities Monitoring form (discretionary).

DATA PROTECTION
The information you provide in this application form will be entered into a manual filing system and onto a computerised recruitment system and as such is covered by the rules set out by Data Protection legislation.

Post applied for:
Preferred location:
1. Personal Details
Title: / Surname/family name(s):
(Mr, Ms, Mrs, Miss, Dr) / Forename(s):
Previous family name(s): / Previous forename(s):
Place of birth: / National Insurance No:
Date of birth: / Nationality:
Non-UK British Citizens: Is your stay in the UK free of restrictions?-select-YesNo
You must include a copy of your passport which shows that your
stay in the UK is free of restrictions. Photocopy of passport included?-select-YesNo
If no, please state why not:
2. Contact Details
Current full
postal address: / Address line 1:
Town/city:
County:
Postcode:
If applicable, please provide an email address for us to correspond with you about your application:
Email address:
How long have you been residing at the above address? / year(s) and month(s)
Telephone numbers (including area code)
Home:
Work:
Mobile: / May we contact you at:
-select-YesNo
-select-YesNo
-select-YesNo
3. Relationships
If you are related to, or have a close personal relationship/friendship with anyone working for Warwickshire Police/West Mercia Police, please state their name, status within the organisation and relationship to you:
Name / Status / Relationship
4. Driving Qualifications
Do you hold a current, valid full UK driving licence?-select-YesNo
5. Employment and Education History
References will be requested for the last three years or previous two employers (if applicable, whichever is longer). Include any educational establishments that you have been a student of during this period, or explanations for any gaps in your employment history.
Current or most recent employer/educational establishment
Current/organisation name:
Post held:
Start date: / MM/YYYY / End date: / MM/YYYY
Current/most recent duties and responsibilities:
Contact for reference purposes:
Do you wish to be consulted before this referee is approached? / -select-YesNo
Address:
Town/city:
County: / Postcode:
Email: / Tel no:
Other referees to cover the last five years, with most recent first:
Company/organisation name:
Contact for reference purposes:
Address:
Town/city:
County: / Postcode:
Email: / Tel no:
Do you wish to be consulted before this referee is approached? / -select-YesNo
Company/organisation name:
Contact for reference purposes:
Address:
Town/city:
County: / Postcode:
Email: / Tel no:
Do you wish to be consulted before this referee is approached? / -select-YesNo
Company/organisation name:
Contact for reference purposes:
Address:
Town/city:
County: / Postcode:
Email: / Tel no:
Do you wish to be consulted before this referee is approached? / -select-YesNo
Company/organisation name:
Contact for reference purposes:
Address:
Town/city:
County: / Postcode:
Email: / Tel no:
Do you wish to be consulted before this referee is approached? / -select-YesNo
6. Candidate Profile (evidence in support of your application)
Please complete the separately attached Candidate Profile.
7. Cautions and Convictions
Please refer to guidance notes and provide relevant details below:
Please tick here if not applicable:

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Candidate URN:
8. Why do you want to be a volunteer with Warwickshire Police and West Mercia Police?
9. What skills can you bring to Warwickshire Police and West Mercia Police?
Please include details of your IT experience.

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Candidate URN:
10. Declaration
I have read the information given to me about this role. I declare that the information I have provided in this application is true to the best of my knowledge and belief and that I have not withheld any relevant information.
I understand that:

I need to be eligible to apply and have checked my own eligibility against the criteria in the Guidance Notes;
Any police support volunteer role will be subject to the receipt of satisfactory references and vetting checks and may be subject to a medical examination;
If any information provided is found to be untrue or is found to have been deliberately withheld, this will result in any offer of employment being withdrawn;
I must inform People Services or the Community Volunteer Co-ordinator without delay of any change in my circumstances;
The Chief Constable retains the right to reject any application without giving reasons.

By ticking this box, I declare that I have read and agree to the above conditions:
Name: / Date of application:

Please be advised we are unable to progress our vetting inquiries without verification of your ID. To avoid delay you MUST take your original identity documents to the front counter of your nearest Warwickshire Police or West Mercia Police station for verification and for return by internal post to HR Vacancies at Hindlip Hall.

ID can only be verified at the following police stations:

Nuneaton, Rugby, Leamington Spa, Stratford upon Avon;
Hereford, Worcester, Kidderminster, Redditch, Telford and Shrewsbury.

Please email your completed forms to:

PROTECT - PERSONAL (when completed)

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Rev 01/15

Equal Opportunities

The Police Service is an equal opportunities employer and is determined to ensure that:

the workforce reflects the diverse society which it serves and that the working environment is free from any form of discrimination, victimisation or harassment;
no job applicant or employee is treated more or less favourably on the grounds of sex, gender reassignment, sexual orientation, age, marital status, pregnancy and maternity, race, colour, nationality, ethnic or national origins, religion or belief or disability. This is subject to the Police Service engaging in a positive action scheme which intends to overcome or minimise a person's disadvantage; and
no job applicant or employee is disadvantaged by a provision, criterion or practice which cannot be shown to be a proportionate means of achieving a legitimate aim.

The information on this form is for monitoring purposes only and will not be made available to those assessing your application, or affect your application in any way. Please note that information disclosed for diversity monitoring purposes may be used by Warwickshire Police and West Mercia Police when publishing reports in accordance with the public sector equality duty, no one however, will be identified personally.

This information forms no part of the recruitment process. It will be detached from your application on receipt.

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Age18-2526-40 41-55 Over 55
SexFemaleMale
Disability*YesNo
Race
White
British Irish
Any other White background
Mixed
White AsianWhite Black Caribbean
White Black AfricanAny other Mixed background
Asian or Asian British
BangladeshiPakistani
IndianAny other Asian background
Black or Black British
African Caribbean
Any other Black background
Chinese or other ethnic group
Chinese Prefer not to say
Any other (please state: )
Gender REASSIGNMENT
Transsexual / Prefer not to say
Marital status
Civil partnership / Separated
Cohabiting/partnered / Single
Divorced / Widowed
Married / Prefer not to say
Sexual orientation
Bisexual / Heterosexual
Gay/Lesbian / Prefer not to say
Religion and Belief
Buddhist / Muslim
Christian / Sikh
Hindu / None
Jewish / Prefer not to say
Other (please state):
Pregnancy and Maternity
Are you pregnant or have you given birth in
the last 26 weeks?Yes / No

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*Under the Equality Act 2010 a person is defined as disabled if they have (or have recovered from) a physical or mental impairment and the impairment has a substantial and long-term adverse effect on the person's ability to carry out normal day-to-day activities.

PROTECT - PERSONAL