Thank You for Your Interest in Applying to Be Licensed As a Chaperone/Matron

(Please retain this front sheet for your records)

ISET Team,(Tel. 443 5134)
Cordingley Building, ( Tel 443 5147)
Scotchbarn Lane,
Prescot
L35 7JD
Dear Applicant (Knowsley Residents only.)

Thank you for your interest in applying to be licensed as a Chaperone/Matron.

Please find enclosed the application form. Please complete the questions as best you can. There may be some questions that you cannot fully answer, the reasons for this is that it is helpful for us to understand your current level of experience.

Please return the form to the above address for my attention with 2 photos and necessary payment by cheque payable to Knowsley Metropolitan Borough Council.

After submitting this application you will receivea Criminal Records Bureau (CRB) form (This is now called a DBS form – Disclosure and Barring Scheme) which you should complete and return in person.

Please get in touch if you do not receive this within 10 days of submitting your application.

If you are applying as a volunteer you will be submitting your form and documents to Human Resources in Huyton in person.

If you are applying as a professionalthen you will need to contact me to arrange a time to meet me or a colleague to submit your completed disclosure application in person.

We will be closing all applications that do not submit a CRB (DBS) application within 3 months of receipt.

Once you receive your CRB (DBS) form back from the CRB/DBS then you need to phone me to let me know, the council no longer receives a copy of this. Only you will receive this copy.

We deliver training which is only twice a year. Currently we deliver the training in March and September. This is usually on Tuesday evenings. There is no additional cost for this training. You will receive letters about this training to advise you when it is coming up.

However if you applying at a time close to the training dates then please call to ensure you find out the times and dates and book yourself onto the training. For the majority of applicants this training is essential to becoming licensed.

For those with limited previous experience of working with children it may be necessary to arrange a 10 minute interview where you will be asked a few questions in support of your application.

Please ensure that where you have experience, that at least one referee can give support to your experience of working with children.

Only when all items including the CRB (DBS) are processed and attending training(Or providing evidence of recent training) can the licence application be completed.

Yours sincerely

Phil Ball. Contact: 0151 443 5134

School Attendance Improvement Officer

(Please note that the CRB (DBS) form usually takes from 1 month to considerably longer to be processed by the Criminal Records Bureau, we have no input or control in this process.)

There have been some changes to the

application process.

So please ensure you read this letter carefully.

School Attendance

Service

THE CHILDREN (PERFORMANCES) REGULATIONS 1968

APPLICATION FOR APPROVAL AS A MATRON

1)Surname ……………………………. Forename(s) ……………………………

Address ……………………………………………………………………………

………………………………………………………………………………………

Post Code…………………………. Date of Birth ……………………………...

Tel No (Home)……………………. Work ………………………………………

Mobile…………………………………….

2)Have you been employed previously as a “Matron” in either this Authority or others? Please state:

Authority / From / To / Details

3)Please give brief details of any work, voluntary or paid, that you have undertaken involving children. You should indicate your level of responsibility and whether you performed the role unsupported. You should indicate when you performed the role and for what duration. (e.g. 30 mins or 3 hrs, regularly up to June 2008)

………………………………………………………………………………………

……………………………………………………………………………………….

………………………………………………………………………………………

……………………………………………………………………………………….

4)If you have not already answered these points then please give examples relating to the points below if you are able to:

a) Being solely responsible for a number of children at one time.

b) Where you have had to challenge something for the benefit of children in your care.

c) Where you have had to occupy a group of children for a length of time.

………………………………………………………………………………………...

…………………………………………………………………………………………

5)Do you have a valid driving licence? ……………………………………………..

6)Does your car insurance allow you to carry passengers whilst you are employed as a chaperone? (Business class insurance)

………………………………………………………………………………………..

7)Do you have any current Safeguarding or Child protection training please give details –

(This may affect your need to attend our training or part of the training, Please provide copies of certificates within last 12 months if you are able.)

…………………………………………………………………………………………

………………………………………………………………………………………….

8)Please give below the names, addresses and occupation/relationship of two referees. They should be aware of your experience and suitability to undertake full responsibility for children. (The referees should not be related to yourself.)

1. …………………………..2. ………………………….

…………………………. ………………………….

Tel No: …………………….Tel No: …………………….

Relationship…………………..Relationship………………….

Known since……………………..Known since……………………..

This application must be accompanied bytwo passport size photographs

If granted, this Licence will be valid for a period for three years from the date the CRB certificate is issued.

I am applying for a Chaperone Licence as a professional. (Cost £47 -Cheque.)
Please Sign ______
OR as a volunteer for this agency ______(Name of Agency).
Please Sign______(Cost £13-Cheque.)

I confirm that the information provided in this application is correct. I understand that the Authority will need to make further enquiries regarding any possible convictions I may have. I also understand that I may be liable to prosecution if I have wilfully stated in this application anything I know to be false or did not believe to be true.

Signed…………………………………….Date………………………………………

For matrons applying in a professional capacity.

The School Attendance Service occasionally receives requests from Theatres and Production Companies to supply them with details of authorised matrons. This is in order that they can contact the Matron to offer short-term employment. Further discussions are then strictly between the enquirer and the Matron.

Should your application be successful do you want us to release your name, address and telephone number to theatres and production companies? Your decision on this matter may be changed at any time by notifying this office in writing.

Yes……………………………………….No…………………………………………..

SignatureSignature

Please sign the relevant section and delete the other.

Please return this form to:Phil Ball (443 5134)

School Attendance Improvement Officer

(Child Employment & Performance Licensing)

ISET Team, (School Attendance Service)

CordingleyBuilding,

Scotchbarn Lane,

Prescot

L35 7JD

Chaperone Checklist.
Please initial.
I have attended the Chaperone training and have understood the duties and responsibilities of a chaperone and the duty to safeguard. I have also understood the signs and symptoms if abuse and what safeguarding entails.
I understand that I have a duty to safeguard the children in my care –
I understand that I have a duty to inform the department of health and wellbeing of any significant safeguarding concern–
I understand that I have a duty to inform the local authority regarding any significant issue relating to child performances –
I have been given contact details for Knowsley health and well being team and KnowsleySchool attendance service –
I understand that I should attend the training provided in the first six months and then every two years following or my licence may be reviewed –
I understand that I have a duty to be aware of significant information when working as a chaperone-
This will include – The applicants name and location, the fire evacuation procedure, the first aid point and first aider, an emergency contact for each child in my care, any additional
needs a child may have, a clear procedure or programme for the performance, and a clear procedure for receiving and handing over care of children.
I understand that it is my responsibility to inform the local authority if any of the following changes:
My home Address or contact details,
My Legal Name,
My ability to perform the role.
(These changes will not necessarily invalidate your licence
but the local authority should be made aware.)
Print:- ______Signed:-______Date:-______

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