Local Police Check Instructions: London Region London

Transcription

1 Local Police Check Instructions: London Region London To obtain a police check in London, volunteers must visit the location below in person. The attached letter (please put the applying volunteer s name in the blank) forms, and two pieces of valid, government issued ID are required; one of these pieces of ID must include a photo. Processing time in this region is 2-3 weeks. Completed checks must be picked up by the volunteer. Please Note: The attached application form must be printed on legal sized paper (8.5x14). If you are unable to print the form accordingly, please visit the station below to obtain a copy of the form. CHECK REQUIRED The Meeting House requires volunteers request the appropriate police check based on the following criteria: volunteers born after December 31, 1985 require a Canadian Police Information Check or a Canadian Criminal Record Check with Local Police Information completed online through Backcheck, and volunteers born before January 1, 1986 require a Vulnerable Sector Check. LOCATIONS 601 Dundas St., London (M,T, TH,F, 8:30am-4pm) Closed Wednesdays and Holidays COST Volunteers will be required to pay $15 when submitting their check (the attached letter is required in order to receive this reduced cost). If needed, volunteers can submit the receipt for their police check to The Meeting House for reimbursement. Please submit the receipt along with the first name, last name, and mailing address of the person the cheque is to be made payable to, along with the first and last name of the person that the police check is for (if different than the person who paid for it i.e. an LIT volunteer). Cheques will only be issued if a photocopy or original of a valid police check is also submitted at the same time. EXAMPLES OF ACCEPTABLE FORMS OF ID Age of Majority card Driver's Licence Birth Certificate Citizenship card Passport Military identification card SUBMITTING COMPLETED CHECKS TO THE MEETING HOUSE Volunteers will receive their completed check in the mail. The original check or a photocopy of the check must be submitted to their ministry coordinator or lead pastor within 30 days of the date of completion on the check. If submitting a photocopy, the coordinator or pastor must verify the original check and sign and date the photocopy before submitting it to the office. ADDITIONAL INFORMATION For further information please visit: This page is for your information only. Please do not submit this page to your local police station.

2 a church for people who aren t into church Records Division 601 Dundas Street London, ON N6B 1X1 Please consider this letter as our confirmation to engage as a volunteer serving with The Meeting House in London, Ontario. We appreciate your proceeding with the vulnerable position screening check accordingly. Sincerely, Roger Massie Data Support Coordinator 2700 Bristol Circle, Oakville, ON L6H 6E1 Phone: Fax: website: data@themeetinghouse.com

3 Applicants Information Must Print Legibly Under Each Heading. POLICE VULNERABLE SECTOR CHECK (This search is restricted to applicants working/volunteering with children or the vulnerable sector) Last Name First Name Middle Name Date of Request (yyyy/mm/dd) Maiden Name or other (Sur)names used Maiden Name or other (Sur)names used # and Street Name Apt/Unit # City Province Postal Code Date of Birth (yyyy/mm/dd) Place of Birth Gender Address History - include all addresses where you have resided in the past 5 years. # and Street Name Apt/Unit # City Province Reason for Request (state below ) Self Declaration of Criminal Record Reason: (if other, please specify) [ ] Volunteer [ ] Employment [ ] Other Attached No Record What is the paid or volunteer position: Name of the employer or organization UNIT 1. TO BE COMPLETED BY APPLICANT Which of the vulnerable sector will you be working / volunteering with? (check all that apply) [ ] Children [ ] Elderly [ ] Physically Disabled [ ] Mentally Disabled [ ] Infirm Details regarding the responsibilities towards the VULNERABLE SECTOR: Extra copy (Additional Fees Apply): Reason for each copy requested: Identification one form MUST be Government Issued that includes the applicant s name, date of birth, signature and photo. Type of I.D. produced ID number Type of I.D. produced Proof of London Address Contact Information Res. Phone Bus. Phone Cell Phone [ ] Unsupervised Setting The Police Vulnerable Sector Check will include the following information as it exists on the date of the search: Outstanding entries, such as charges, judicial orders, Peace Bonds, Probation and Prohibition orders Criminal convictions (summary and indictable) from CPIC and/or local databases. Absolute and conditional discharges. Family court restraining orders. Criminal charges resulting in dispositions including, but not limited to, Withdrawn, Dismissed, and cases of Not Criminally Responsible by Reason of Mental Disorder as listed on local indices. Police contacts including but not limited to theft, weapons, sex offences, or violent, harmful or threatening behaviour which may or may not have involved a mental health incident where no charges were laid. All pardoned criminal convictions, including non sex offences, identified as a result of a Vulnerable Sector Verification search and authorized for release by the Minister of Public Safety and Emergency Preparedness. Consent 1. I hereby release and discharge the s Board and all members and employees of the from any and all actions, claims and demands for damages, loss or injury howsoever arising which may hereafter be sustained by myself as a result of the disclosure of information by the. I hereby authorize the to inquire into and disclose the results of any police records to me including: outstanding entries, such as charges, judicial orders, peace bonds, probation and prohibition orders; criminal convictions (summary and indictable); absolute and conditional discharges; family court restraining orders; criminal charges resulting in dispositions including, but not limited to, withdrawn, dismissed, and cases of not criminally responsible by reason of mental disorder; police contacts including but not limited to theft, weapons, sex offences, or violent, harmful and threatening behaviour which may or may not have involved a mental health incident where no charges were laid; all pardoned criminal convictions, including non sex offences, identified as a result of a Vulnerable Sector Verification search and authorized for release by the Minister of Public Safety and Emergency Preparedness and to conduct a local police contact search with any Police Service in Canada. 2. I certify that the information provided by me in this application is true and correct to the best of my knowledge and belief. I have read this consent, understand it and agree to it in its entirety. 3. For Applicants that are 18 years of age or older, I hereby consent to a search being made in the automated criminal records retrieval system maintained by the Royal Canadian Mounted Police to find out if I have been convicted of, and been granted a pardon for, any of the sexual offences that are listed in the schedule to the Criminal Records Act. I understand that, as a result of giving this consent, if I am suspected of being the person named in a criminal record for one of the sexual offences listed in the schedule to the Criminal Records Act in respect of which a pardon was granted or issued, I will be requested to provide fingerprints to confirm that record and that record may be provided by the Commissioner of the Royal Canadian Mounted Police to the Minister of Public Safety, who may then disclose all or part of the information contained in that record to a police force or other authorized body. That police force or authorized body will then disclose that information to me. If I further consent in writing to disclosure of that information to the person or organization referred to above that requested the verification, that information will be disclosed to that person or organization. Applicant s Signature: Date:

4 UNIT 2. POLICE USE ONLY Application Verified by: POLICE VULNERABLE SECTOR CHECK (This search is restricted to applicants working / volunteering with children or the vulnerable sector) (Print Name) (Signature) Applicant Information Last Name First Name Middle Name Date of Birth Gender Request and Fee received by: Fee: Paid by: RESULTS FOR RCMP NATIONAL REPOSITORY CRIMINAL RECORD CHECK AND VULNERABLE SECTOR SCREENING (Vulnerable Sector Screening is not conducted for applicants under 18 years of age) NEGATIVE (not confirmed by prints) Based solely on the name(s) and date of birth provided and the criminal record information declared by the applicant, a search of the RCMP National Repository of Criminal Records, including pardoned sex offender records, did not identify any records with the name(s) and date of birth of the applicant. Positive identification that a criminal record does or does not exist at the RCMP National Repository of Criminal Records can only be confirmed by fingerprint comparison. Delays do exist between a conviction being rendered in court, and the details being accessible on the RCMP National Repository of Criminal Records. Not all offences are reported to the RCMP National Repository of Criminal Records. NEGATIVE ( confirmed by prints) CRIMINAL RECORD (not confirmed by prints) Based on the fingerprints, name(s), and date of birth submitted by the applicant, this message certifies that a search of the RCMP National Repository of Criminal Records, including pardoned sex offender records, did not identify any records associated with the applicant that may be disclosed in accordance with federal laws. Delays do exist between a conviction being rendered in court, and the details being accessible on the RCMP National Repository of Criminal Records. Not all offences are reported to the RCMP National Repository of Criminal Records. Based solely on the name(s) and date of birth provided and the criminal record information declared by the applicant, a search of the RCMP National Repository of Criminal Records, including pardoned sex offender records, has resulted in a possible match to a registered criminal record, but not to a pardoned sex offender record. Positive identification that a criminal record does or does not exist at the RCMP National Repository of Criminal Records can only be confirmed by fingerprint comparison. As such, the criminal record information declared by the applicant does not constitute a Certified Criminal Record by the RCMP. Delays do exist between a conviction being rendered in court, and the details being accessible on the RCMP National Repository of Criminal Records. Not all offences are reported to the RCMP National Repository of Criminal Records. CRIMINAL RECORD (confirmed by prints) Based on the fingerprints, name(s), and date of birth submitted by the applicant, this message certifies that a search of the RCMP National Repository of Criminal Records identified that the fingerprints submitted by the applicant were certified as identical to fingerprints registered under criminal FPS Number. The fingerprints submitted by the applicant did not match to a pardoned sex offender record. Delays do exist between a conviction being rendered in court, and the details being accessible on the RCMP National Repository of Criminal Records. Not all offences are reported to the RCMP National Repository of Criminal Records. This document may not contain all criminal record convictions associated with the applicant. Vulnerable Sector Screening Conducted. Information authorized for release. Unable to complete Vulnerable Sector Screening. RESULTS FOR: LOCAL CRIMINAL RECORD OR LOCAL POLICE INFORMATION NEGATIVE No information was revealed that can be disclosed in accordance with federal laws and CPIC policies. POSITIVE Local Criminal Record POSITIVE Local Police Information Date of Search Clerk # NOT VALID UNLESS EMBOSSED BY LONDON POLICE SEAL Response(s) have not been received from all police agencies in relation to previous addresses. A police record check is current as of the date it is completed. Your completed record check will remain available for 6 months from the date it was completed. Any police record check not picked up by that date will be destroyed. The London Police service will not reprocess these record checks or refund any fees. It is your employer/prospective employer or organization s function to determine if the record check is current enough to be accepted for the position applied for. The London Police Services Board, its officers, agents and employees, shall have no responsibility or obligation to make such a determination. Personal information contained on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act, s.28(2), s.32(b) and the Police Services Act, s.41 for the purpose of processing this police record check. Questions concerning this collection should be directed to, Records Screening Unit, 601 Dundas St, London ON, N6B 1X1 Form No. LP /08/15 See attached page(s)

5 Declaration of Criminal Record (To be Completed by Applicant) Self Declaration of a Criminal Record is a process whereby the applicant declares their adult criminal record convictions to the Police Service in accordance with CPIC policy requirements and federal laws. Last Name: First Name Middle Name Date of Birth (yy/mm/dd) Maiden Name or other (Sur)names used Place of Birth Gender Self Declaration of a Criminal Record Does not constitute a Certified Criminal Record by the RCMP May not contain all criminal record convictions Self Declaration should NOT include: Conviction for which a pardon has been received. Youth Convictions (Youth Criminal Justice Act (YCJA)). Absolute/Conditional Discharges. Offences where there were no convictions. Provincial/Municipal Offences. Charges dealt with outside of Canada In order to release criminal convictions identified through a name based query, the Police Service must be satisfied that the applicant's declared criminal record information is a match to their registered criminal record held at the RCMP National Repository of Criminal Records. If a police service is not satisfied that the applicant's declared criminal record information is a match to their registered criminal record held at the RCMP National Repository of Criminal Records they may require the applicant to submit fingerprints to the RCMP National Repository of Criminal Records. Additional fees will apply if fingerprints are required. NOTE: A Certified Criminal Record can only be issued based on the submission of fingerprints to the RCMP National Repository of Criminal Records. OFFENCE DATE OF SENTENCE (yy/mm/dd) SENTENCE LOCATION Applicant s Signature Personal information contained on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act, s.28(2), s.32(b) and the Police Services Act, s.41 for the purpose of processing this police record check. Questions concerning this collection should be directed to, Records Screening Unit, 601 Dundas St, London ON, N6B 1X1 Form No. LP /05/30