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Child Protection Policy
Personal Profile Form To be completed by all new volunteers/employees. 1. Organisation’s Name: ___________________________________________________ 2. Personal Details Title: ______ Forename: ____________________ Surname: ____________________ Date of Birth: ____________ Telephone No (incl STD code): _________________________Address: ______________________________________________________________ ________________________________________________ Occupation: _________________________________ 3. Qualifications/Training - Please enter details of any qualifications or training courses you have attended which are relevant to caring for young children. Date(s) Title of Qualification/Training Subjects Studied Length of Course Name of Organisation 4. Experience - Please give
details of experience of working with under 16’s. Other comments: 5. Referees - Please provide the names and addresses of TWO responsible persons for reference purposes. Referees should not be related to you and, where possible, should have a knowledge of your ability to care for or be in the proximity of children. All references will be taken up. You should secure prior agreement of referees before providing their names. Referee 1 Name: ______________________________________ Address: ____________________________________ _______________________________________________ _______________________ Postcode: _____________ Referee 2 Name: ______________________________________ Address: ____________________________________ ______________________________________________ _______________________ Postcode: _____________ 6. Declaration - I have read and understood the organisation’s Child Protection Policy and agree to CONFIDENTIAL vetting procedures. I agree to inform the organisation of any change in circumstances. Signed: _____________________________________________
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