Independent Custody Visiting Application Form

Independent Custody Visitor Application Form

Title*
First Name(s)*
Last Name*
Any other names you have been known by
Permanent Home Address*
Number of years at this address*
(If less than 5 years please complete previous address)
Previous Address
Number of years at this address
Date of Birth*
Age*
Place of Birth*
Nationality*
National Insurance Number*
Home Telephone Number*
Work Telephone Number
Mobile Telephone Number
Email*
Have you ever been a Custody Visitor before? If so please provide details
Custody Visitors need to be impartial and independent. To enable us to identify any possible conflicts of interest please complete the section below
Are you a police officer or special constable?*
Are you a member of police staff?*
Are you a Magistrate?*
Are you a Lawyer?*
Are you a Probation Officer?*
Are you a member of staff of the Northamptonshire Office of the Police and Crime Commissioner, or their immediate family?*
Have you retired from any of these roles in the last 5 years?*
If you have answered yes to any of the above please provide further details:
Please provide us with details of any part-time or full-time work over the last 5 years:*
Please include 'Name and address of employer' 'Dates' and 'Position held and duties'
Do you do any other voluntary work or public service?*
If 'Yes' please give details below:
Why would you like to be an Independent Custody Visitor?*
Do you have a current full car or motorcycle license?*
This will not affect your application but may influence which tasks you are set, if successful.
Please tell us what skills, experience and qualities you have that would make you a good Custody Visitor. Please provide examples under each of the headings below.*
Objectivity/Impartiality
Communication and listening skills*
Communication and listening skills
Confidentiality*
Confidentiality
Awareness of diversity and equality*
Awareness of diversity and equality
Teamwork*
Teamwork
Do you consider yourself to be disabled?*
Do you have any medical condition that may affect your ability to carry out the duties of an Independent Custody Visitor?*
Are there any special arrangements you would require if attending an interview? (eg. access, disabled parking)*
If you have answered 'Yes' to any of the above questions please provide more details below.
This will not necessarily affect your application.
**The Police and Crime Commissioner is an equal opportunity employer and actively encourages applications from people with disabilities. Applicants with disabilities who demonstrate that they meet the essential criteria in the Person Specification will be guaranteed an interview. The Equality Act 2010 defines a disabled person as someone who has: “A physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities” **
In the last five years have you had any criminal convictions or been convicted of any offence punishable by imprisonment?*
If you have answered 'Yes' to the above question please provide more details below.
The inclusion of this question and the provision of the information is a requirement in all applications but may not necessarily affect your application. Offences covered by the Rehabilitation of Offenders Act 1974 need not be declared above if spent.
To help us with recruitment in the future, please advise how/where you learnt about the Independent Custody Visiting scheme?*
Please give the name of two referees who have agreed to support your application.*
One should be a professional who knows you e.g. teacher/solicitor accountant/community leader or a manager at work. The other can be a character reference who should have known you for at least two years. (Referees should not be family members).
Address*
Email Address*
Telephone Number*
Position*
Referee 2 Name*
Address*
Telephone Number*
Email Address*
Position*
DECLARATION - By submitting this form I agree to Northamptonshire Police undertaking a security vetting check in connection with my application as a volunteer. I have read the information supplied to me concerning the duties and responsibilities of an Independent Custody Visitor and would be prepared, if my application is accepted, to complete the appropriate undertaking in respect of confidentiality.

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Independent Custody Visiting Application Form

Independent Custody Visitor Application Form