Access ni vetting Check – Club application form


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NameAccess ni vetting Check – Club application form
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Access NI Vetting Check – Club application form



Your club is committed to providing a safe and secure environment for children and young people to participate in football. As part of your club’s safe recruitment process all people who are engaged in a regulated activity i.e. unsupervised coaching of children and young people on a regular basis should complete an Enhanced Disclosure Check through Access NI. Please complete the application in full and submit it to the Irish FA via your club welfare officer.


Notes for the Welfare Officer: Under safeguarding vulnerable groups legislation;

Any person who is barred from working with children or vulnerable adults will be committing an offence if they work or volunteer, or try to work or volunteer with these vulnerable groups.

Any organisation who knowingly employs a person who is barred from working with children and vulnerable adults will also be breaking the law.

An organisation who works with vulnerable groups, is legally required to inform the disclosure and Barring Service if they have dismissed an employee or volunteer because they have harmed a child or vulnerable adult, or you would have done so if they had not left.

To view the Irish FA Policy on the Recruitment of Ex-Offenders, Data Handling Policy and the Access NI Code of Practice follow this link: www.irishfa.com/taking-part/youth-football/safeguarding.

Notes for the applicant:

By signing this form, you give permission for us to progress with an application that involves a check against the Barred List. It is a criminal offence to apply for an Enhanced Disclosure check if you are on one of the Barred Lists.

A criminal record will not necessarily prevent an applicant from gaining a position.

Where information has been disclosed, applicants are required to disclose, in confidence, the Access NI Disclosure Certificate that they receive to the club welfare officer as part of the selection process.

The Club will (1) consider the information contained in the Access NI Disclosure Certificate (2) assess whether any convictions are relevant to the role (3) inform you of our decision and (4) return the disclosure certificate to you.

The Club will record their decision, inform the Irish FA and retain this record confidentially.

You may wish to discuss any concerns with the club welfare officer before proceeding with this application.

Section 1

Applicant details

Applicants name

Peter Striker

D.O.B

01/01/1986

Address


1986 Mexico Way

Mexico

BT1 986

Contact number

07719 861986

E-mail

Peter.striker@worldcupmexico86.com

Section 2

Role information

Name of Club/Affiliated Body/League/Irish FA Department

NFS Rovers

Club Welfare Officer

William Officer

Role (i.e. coach, welfare officer)

Coach/Physio/Welfare Officer

Is this a voluntary role?

Yes

X

No




Does this role require you to work, unsupervised with:

Children

X

Vulnerable Adults




Both




Indicate the regularity of the activity (Please tick)


Once a week

X

Any overnight stay




Four or more times in a 30-day period




Four or more times a year, but less than 4 times in any 30-day period




If the position involves working with vulnerable adults, indicate the regularity of the activity

Providing transport




Providing personal care

Handling money

Other (describe activity)

Is there any reason why you cannot take up a position in a Regulated Activity (that is, working regularly in an unsupervised activity with children, young people or vulnerable adults)? If “Yes”, please discuss this, in confidence, with the Welfare Officer, who will arrange to meet you when you receive any Access NI Disclosure Certificate.

Yes




No

X



Section 3

Making an Access NI application

(a) Go to www.nidirect.gov.uk/apply-for-an-enhanced-check-through-a-registered-body

(b) Select the Green Button to Apply for an enhanced check through a registered body.

(c) Create an account by registering your email address and creating a password – keep these details safe as you will need them to track the progress of your application on the Access NI website.

(d) Once you have successfully logged in, you will be taken to the on-line application.

(e) Enter the Irish FA’s PIN number (957015) at Step 1 of the form completion.

(f) Enter the name of the football club you are applying to volunteer for.

(g) Complete the remainder of the form and click on CONFIRM AND PROCEED to finish the on-line process.

(h) The Access NI system will provide you with the 10 digit Access NI reference number. Write this number into the box below and retain a copy of the number for your own use.

2

0

1

6

1

9

8

6

0

0



(i) Your club welfare officer will arrange to meet with you in confidence to discuss any information provided in the Access NI Disclosure Certificate that you receive.

(j) You should know that if you do not disclose the information in any Access NI Disclosure Certificate – regardless of the content – to the club welfare officer, your application will be rejected.



Section 4: Validating the identity of the applicant for the position – to be completed by the appropriate official of the Affiliated Association, League or Club

Three documents should be produced in the name of the applicant; one from Group 1 and two from Group 2. If this is not possible, then four documents from Group 2 should be produced, one of which being a birth certificate issued after the time of birth. At least one of these documents should be photographic identification.



Applicant details as they appear on the ID documentation provided:

Full name




…Peter…Striker………………………………………

Date of Birth

:

0

1

/

0

1

/

1

9

8

6







Current postcode

:

n

f

s

2

0

1

6



I confirm that

  • I have checked the information supplied by the Applicant on this form;

  • I have checked their identity documents in accordance with Access NI Guidance;

  • I have seen the original ID documentation as indicated on the attached sheet;

  • The information I have supplied is complete and true;

  • This position is eligible for an Enhanced Check and, where a Barred List check is being sought, I have made the Applicant aware of this and he/she has given me permission to progress with the application;and,

  • I understand that to knowingly make a false statement for the purpose of getting an Access NI check is a criminal offence.




Date of ID check

:

1

9

/

1

2

/

2

0

1

6

Signed

:

Welfare Officer………………………………….





GROUP 1

GROUP 2

X

Current passport (any nationality)

X

Birth certificate (UK, ROI, Isle of Man or Channel Islands) issued after time of birth



Biometric Residence Permit (UK)

X

Marriage/Civil Partnership Certificate (UK, Isle of Man or Channel Islands)



Current driving licence (UK, ROI, Isle of Man, Channel Islands or any EU country)



HM Forces ID card (UK)



Original birth certificate (UK, Isle of Man or Channel Islands) issue at time of birth





National Insurance Card or notification letter with NI number (UK)















Original long form Irish birth certificate –issued at time of registration of birth



Firearms licence (UK and Channel Islands)



Adoption certificate (UK, Isle of Man or Channel Islands)



Bank / Building Society Account Confirmation Letter









Electoral ID card (NI only)



EU National ID card



Cards carrying the PASS Accreditation logo (UK and Channel Islands)



Senior SmartPass (Translink) (NI only)



Current UK driving licence (old paper version)



Examination certificates (16-18 year olds only)



Bank/Building Society Statement (UK or EEA)*



Credit card statement (UK or EEA)*



Utility Bill (UK or ROI)* – not mobile phone



Benefit statement (UK)*



Addressed payslip*



Mortgage statement (UK or EEA)**



Financial statement (UK)**



P45/60 statement (UK and Channel Islands)**



Land and Property Services Agency rates demand (NI only)**



Work Permit/Visa (UK) (UK Residence Permit)**.



Letter from a Head Teacher or Further Education College Principal (16-18 year olds in full time education – only to be used when other documentation routes are exhausted)**

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