Swimming NZ Police Vetting Consent to Disclose Form

Police Vetting Consent & Disclose Form

Swimming NZ
Please note that police vetting applications will not be processed between 10 April – 3 May 2026 due to staff absence.

Please apply before this date if you are seeking Police Vetting.
Application Information
Family Name (Primary)*
First/Middle Name(s)*
Gender*
Date of Birth*
DD/MM/YYYY
Place of Birth*
Town/City/State
Country of Birth*
Town/City/State
NZ Drivers Licence Number
If Applicable
Name of Parent or Guardian (if 14 or 15 years old)
If Applicable
Previous Names (if applicable)
Please include other alias or alternate names; married name if not your primary name; previous/maiden/name changed by deed poll or statutory declaration. Please include ALL names (first, middle and last) for each alias/previous name
Address*

Flat/Number

Street

SuburbTown/City

Postal / Zip Code
Click here to view the Police Vetting website for further information
Authorisation of person being vetted:*

I confirm that the information I have provided in this form relates to me and is correctI have read and understood the information aboveI authorise New Zealand Police to disclose any personal information relevant to my application (as described above) to the agency making this request for the purpose of assessing my suitability
Digital Signature*
Parent/Guardian Signature (if 14 or 15 years)
Date Signed & Completed*
Today's Date - DD/MM/YYYY
Consent to Disclose Form
Name of Person Being Vetted*

First NameLast Name
SNZ Membership Number
SNZ Membership Type
Club Name*
Description of the role of the person being vetted*
Which groups will the person being vetted be working with (select all that apply)*

Children or Young PeopleVulnerable Adults
Are you being vetted as a:

Paid WorkerVolunteer
Are you being vetted as a:*

Paid WorkerVolunteer
Has the person being vetted previously been Police vetted by Swimming NZ?*

YesNo
Is the person being vetted still working in the role for which your agency last obtained a Police vet?*

YesNo - the person being vetted is applying for a new role or position
What is the job title of the person being vetted?*
Email*
example@example.com
Contact Number*
Proof of Identification - Primary

eg: Passport - please note you can opt to email to policevetting@swimming.org.nz as the alternative option for submitting both forms of ID
Cancelof
Proof of Identification - Secondary

eg: NZ Drivers Licence - please note you can opt to email to policevetting@swimming.org.nz as the alternative option for submitting both forms of ID
Cancelof
Police Vetting Application Form

ie: the application form on our website - please note you can opt to email to policevetting@swimming.org.nz as the alternative option for submitting this application form
Cancelof
By ticking this box I am confirming that if I haven't attached my completed Police Vetting application and two forms of identification to this consent to disclose form, I have emailed this information to policevetting@swimming.org.nz
Click here to view the Police Vetting Policy and for more information about the process
To find out more about Jot Form's privicy please click here.
Should be Empty:

Police Vetting Consent & Disclose Form

Please note that police vetting applications will not be processed between 10 April – 3 May 2026 due to staff absence.

Application Information

Consent to Disclose Form