Positions of Trust Application Form

To be completed by anyone nominated or applying for appointment into voluntary positions that are:-

* Regulated roles with children, young people and adults at risk. (A regulated role is face to face contact (supervision) with/of children (any person under the age of 18) or adults at risk on more than 3 occasions in a 30-day period OR overnight supervision between 2am & 6am.

OR

* Charity Trustees (check club or county constitution to establish who the Charity Trustees are in the YFC club or YFC county federation).

These roles are considered as being in a position of trust will be subject to safe recruitment procedures to protect members of YFC, you as the applicant, and the YFC club and/or YFC county federation and/or the wider YFC community including the NFYFC.

Applicants should be aware that positions of trust are subject to the Sexual Offences Act 2003 legislation and should refer to the Safeguarding Children, Young people and Adults at Risk policy for more information.

Name

First NameLast Name

Date of Birth

Date

Address

Address line 1

Address line 2

TownCounty

Post Code

Telephone number

Mobile telephone number

Email

example@example.com

YFC role nominated/applied for

Please outline any relevant skills and abilities, experience or interests that are relevant to this role.

References

Two references are required as part of the safe recruitment process.

Please provide details of two independent referees (one can be internal i.e. within the YFC community and one from outside of the YFC community – referees should not be related to you or from your household) who will be able to comment on your ability and suitability to work with children, young people or adults at risk.

The referees should be independent of one another (not known to one another) and must not be related to you (family or from your household).

Referee one (may be from the YFC Community)

How long and in what capacity is this person known to you?

Referee one

Referee two (from outside of the YFC Community)

How long and in what capacity is this person known to you?

Referee two

Due to the nature of a position of trust you are advised that you should declare all disciplinary sanctions and/or investigations, allegations, cautions, convictions, including ‘spent’ convictions (under the provisions of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 as amended by the Rehabilitation of Offenders Act 1974 (Exceptions Amendment) Order 1986).

Failure to disclose in full the matters required to be disclosed by this Declaration could result in removal from your position and membership of YFC. Not all declarations will exclude you from volunteering with YFC; all information provided will be considered as part of your application in line with safe recruitment procedures.

For completion by the individual

Have you ever been convicted of any criminal offences, including cautions, warnings or other sanctions?

*(If 'YES' please state the conviction)

Date of Conviction

Date

Have you ever been known to any social services department as being an actual or potential risk to children and young people?

Have you ever been the subject of any disciplinary investigation and/or sanction by any organisation due to concerns about your behaviour towards children or service users?

*(If 'YES' please provide further information)

Confirmation of Declaration (tick boxes below)

Signature of named individual

Print name

Date