Application Form South Australia Police Volunteer

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RF2139
APPLICATION FORM
SOUTH AUSTRALIA POLICE VOLUNTEER
You must complete this form in your own handwriting.
Please answer all questions fully and correctly. Any questions not fully or accurately answered may
make you liable to be disqualified, and if appointed, to be de-registered as a Police Volunteer.
If there is insufficient space on this form to record all details, additional information should be attached.
As an applicant for the Police Volunteers Program, you must be;
An Australian Citizen or have permanent resident status
Of 12 years or above (please note that some Volunteer programs may require persons to be
Affix one colour
of 18 years or above) and have parental or guardian approval to apply.
passport size
IMPORTANT:
photograph of
Personally present the completed application form, photograph and formal photographic identification
applicant here
(e.g. Drivers licence) to any Police Station. A Police Officer or Administrative Services Officer will verify
identification on page 4. SAPOL collects information on this form for the purpose of registering and
assessing your interest to become a volunteer. Your personal information will not be disclosed to any
external party without your consent except where required or authorised by law.
If you have any questions about this application, telephone 08 7322 3216 / 08 7322 3217.
Personal Details
Title:
Family Name:
Given Name(s): (in full)
Maiden Name / Previous Surname:
/
/
Other names you have used or are known by:
Date of Birth:
Full Address:
Postcode:
Postal Address: (if different from above)
Postcode:
Current Occupation:
(
)
(
)
Telephone:
Home:
Business:
Mobile:
Email Address:
Place of Birth:
If not born in Australia, date of citizenship or permanent residency
(Please attach evidence when
/
/
obtained:
submitting the application)
Do you wish to be identified as:
An Aboriginal person?
Yes
No
Yes
No
A Torres Strait Islander?
Yes
No
A person from a multicultural background?
A person with disability?
Yes
No
If appropriate, please describe your cultural background and/or disability. (Please note, identifying as a person with disability will not preclude you
from becoming a volunteer however, some roles may be restricted. Identifying as a person of multicultural background or a person with disability
may be subject to disclosure within SAPOL for reporting purposes.)
What is your first language?
Are you proficient in the use of any other language(s)?
Yes
No
If yes, what language(s)
Previous Residence(s) within last ten years
No.
Street Name
Town/Suburb
Postcode
Period of Residence
/
/
to
/
/
/
/
to
/
/
Revised: 22/09/2016
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