Application form for the role of Police Support Volunteer (PSV)
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1 Application form for the role of Police Support Volunteer (PSV) When completed, this form should be ed to the HR Shared Service Centre: Alternatively you can return the form to: HR Shared Service Centre Derbyshire Constabulary Butterley Hall Ripley Derbyshire DE5 3RS If you are experiencing problems submitting this form, please contact the HR Shared Service Centre on Applicant s full name: Role applied for: Preferred location: For office use only Applicant number: Date received:
2 Personal details: Personal data supplied on this form may be held or verified by computer during the process of your application. Background enquiries undertaken may include reference to personal data held on Police National Computer (PNC). The following information is necessary for security checks to be carried out in accordance with HM Government and Leicestershire Police Security & Vetting Policies. These will only be undertaken if your registration to become a volunteer is progressed, following interview. Surname: First name(s): Title: Mr/ Mrs/ Miss/ Ms Surname at birth: Male/ Female: Place of birth: Any other surnames used: Date of birth: Nationality: Full address: County: Postcode: Date moved in: Previous address: Postcode: Date from: Date to: Previous address: Postcode: Date from: Date to: Home telephone: Mobile telephone: Work telephone: address: Marital status: Single Married Co-Habitant Name of spouse: Spouse date of birth: Please list below anyone else living at your address over the age of 10 years: (If you require more space, please use page 8) Full name: Full name: Full name: Date of birth: Date of birth: Date of birth: Next of kin and contact number for emergency: Name: Relationship to you: Contact address: Telephone number: 2
3 Type of voluntary work: If you have a particular area of interest you would like to become involved in, please state here: Opportunities are varied and will be arranged and agreed with the Neighbourhood Policing Area (NPA) Deputy Commander at the time of interview. Do you have any previous voluntary work experience? Yes / No If 'Yes', please give details below: Availability: Please tick appropriate boxes Morning Afternoon Evening Sat Sun Mon Tue Wed Thurs Fri Skills: Please indicate any skills you have which you would be happy to use in a volunteering role. We will use this list and the information about your availability and location preferences to match you to a suitable volunteering role. IT skills: Please specify: Admin skills: Please specify: A second language: Sign language skills: Supervisory skills: Please specify: Please specify: Please specify: Customer Service skills: Please specify: First aid skills Please specify: Do you hold a full UK Driving Licence: Yes/No Any other skills or abilities: 3
4 Details of current employment/ education: Starting with the most recent please give a detailed description of any full/part time or casual employment or education, business interests or volunteering you have held in the last 3 years. Name, address of business of employer or education Position held and main duties or course title Dates from and to Reason for leaving (if applicable) 4
5 Other information: We are firmly committed to the principles of equal opportunities and encourage applications from all sections of our communities. The information provided will not be used during the process of selection and will be retained by the HR Shared Service Centre for monitoring purposes. Please tick only one box which you feel most appropriately identifies your ethnic group. An ethnic group is a group of people who share certain background characteristics such as language, culture and religion. This provides them with a distinct identity as seen by themselves and others. Your nationality, place of birth or citizenship does not necessarily reflect your ethnic group. White Mixed British Irish Any other White background White and Black Caribbean White and Black African White and Asian Any other Mixed background Chinese Chinese or other ethnic group Any other ethnic group Black or Black British Asian or Asian British Prefer not to say Caribbean African Any other Black background Indian Pakistan Bangladeshi Any other Asian background Do you consider yourself to have a disability? Yes: No: Do you consider yourself to have a learning difficulty? Yes: No: Please give details of any support you may need to assist you in the application process or in your volunteering role: Are you a UK or EU citizen, or a commonwealth citizen, or a foreign national with indefinite leave to remain in the UK? Yes: No: Have you lived in the UK continuously for three years? Yes: No: Are you or have you ever been a member of the British National Party (BNP) or similar organisations whose constitution, aims, objectives or pronouncement may contradict the duty to promote race equality? Yes: No: Do you have any convictions or cautions? Yes: No: If yes, please provide details (If you require more space, please use page 8): 5
6 Do you have any tattoos on your hands, neck, forearms or face: Yes: No: If yes, please provide details: Please note because of the nature of the volunteer placements mentioned overleaf, all Volunteers will be required to undergo a Police check. This can be a lengthy process and we are grateful of your patience and enthusiasm. I confirm that to the best of my knowledge and belief the details I have supplied are true and correct. I understand that if it is subsequently discovered that any statement is false, any placement offered would be withdrawn. If there are any changes in your personal circumstances you must inform the HR Shared Service Centre to ensure the data held is kept up to date. Signature: Date: Full Name: (Please print) Marketing: To enable us to monitor our public relations and marketing activity, please indicate where you found out about us: Tick any that apply. Careers office/school/college/library Social media Friend/family/word of mouth Leicestershire Police website Leicestershire Police promotional material (e.g. leaflet/brochure) Local press Local event e.g. recruitment fair/recruitment stand Agency referral (i.e. YOS, LASBU, Social Services; please specify) Other (please specify) 6
7 Continuation page: 7
8 Many thanks for taking the time to complete the Police Support Volunteer application form. Please send your completed form to the HR Shared Service Centre: Alternatively you can return the form to: HR Shared Service Centre Derbyshire Constabulary Butterley Hall Ripley Derbyshire DE5 3RS If you are experiencing problems submitting this form, please contact the HR Shared Service Centre on If you would like to find out more about volunteering for Leicestershire Police please log onto our website or give us a call. Once we have received your completed application form, we will write to you to invite you to attend a volunteer interview. Thank you for the interest in volunteering for Leicestershire Police. 8
Please note that if you have completed and sent this form electronically, you will be asked to sign it if you are invited to an interview.
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