Independent Custody Visitor Application Form

Please contact us if you would like to request this form in an alternative format.

Forename(s)

Surname

Previous Name(s)

Current Address

Previous Address (if less than 3 years)

Telephone Number

Date of Birth (you must be aged 18 and above to become an ICV)

Place of Birth

Occupation

Employer

Employer Address

Are you or have you ever been a police officer or special constable?

If you have ever been a police officer when did you resign?

If you have ever been a special constable when did you resign?

Are you a member of Police Staff?

Are you a serving Magistrate?

Are you involved in any other type of criminal justice work that could create a conflict of interest? If the answer is yes, please specify

Please give details of any relevant interests or experience (including other voluntary work):

Please use this space to tell us why you would like to volunteer as an Independent Custody Visitor:

Please give the name, addresses, occupations, contact number and email address of two people (who should not be members of your family) who could support your application:

Have you any unspent convictions?

Yes No

If yes, please list all unspent convictions in chronological order. Please note: under the Rehabilitation of Offenders Act, 1974, following a certain period of time which depends on the sentence imposed, all convictions except those resulting in prison sentences of more than 2 ½ years are regarded as spent. This means that sentences of up to 6 months become spent after 7 years and those of between 6 months and 2 ½ years are regarded as spent after 10 years.

How did you hear about us?

DECLARATION:

I agree to the Office of the Police and Crime Commissioner, Bedfordshire making an enquiry to the police in connection with my application to volunteer as an Independent Custody Visitor, I have no objection to referee’s being contacted. I have read the information supplied to me concerning the duties and responsibilities of an Independent Custody Visitor, and would be prepared, if my application is accepted, to undertake all the required duties and responsibilities and to attend training sessions as necessary. I understand the importance of confidentiality.

I declare that the information I have provided is accurate to the best of my knowledge and belief.

Bedfordshire Police Headquarters

Email the Office of the Police and Crime Commissioner

Office of the Bedfordshire Police and Crime Commissioner

Independent Custody Visitor Application Form

Bedfordshire Police AND Crime Commissioner

Bedfordshire PCC