Application for a Certificate of Approval

Size: px
Start display at page:

Download "Application for a Certificate of Approval"

Transcription

1 Private Security Personnel Licensing Authority For more information visit Application for a Certificate of Approval Under the Private Security Personnel and Private Investigators Act What is this form used for? Use this form to apply for a certificate of approval to enable you to work for a licence holder in the private security industry or as a crowd controller (also known as a bouncer or doorman). You can apply for a certificate in one of seven categories. These categories are listed in Section 1. 2 What do you need to complete your application? To complete your application you need to send: A fully completed form A passport style photo (for more information see overleaf) A cheque for $200 (or $220 if you are also applying for a temporary certificate) 3 Completing this form Print clearly in CAPITALS. Use a black or blue pen to complete this form. Answer every question on the form unless the instructions tell you otherwise. 4 Payment Information The fee for filing an application for a Certificate of approval is $200 Temporary certificate of approval is an additional $20 You can only pay by cheque. Make your cheque payable to: The Private Security Personnel Licensing Authority. For a quicker, easier, cheaper way of applying apply online see Application fees are non-refundable. 5 How long will it take to hear the outcome of your application? In normal circumstances it will take a month to hear the outcome of your application. If you have a criminal conviction your application may take longer to process. You can check the progress of your application on 6 Important information If you: Provide false or misleading information to the Licensing Authority, you may be liable for a fine of up to $20,000. Work for a licensee or as a Crowd Controller without holding a Certificate of Approval you could be fined up to $20,000. All personal information provided to the PSPLA will be managed in accordance with the Privacy Act Page 1 For more information visit PSPLA 02/15 - A

2 Photograph Requirements Any photograph of an individual submitted to the Licensing Authority in non-electronic form for the purpose of sections 24, 46, or 111 must: (a) be of good quality; and (b) have been taken not more than 6 months before the date on which it is supplied; and (c) be a full front view of the face, head and shoulders of the person, with the head filling most of the photograph; and (d) have a plain, light coloured background (not white or dark) with no background shadow; and (e) show the individual without a head covering, hat, head band, bandanna or scarf except for religious or medical reasons. In all cases, facial features from the bottom of the chin to the top of the forehead and both edges of the face must be clearly shown; and (f) be a colour photograph; and (g) be a good likeness of the person; and (h) be 45mm high x 35mm wide; and (i) be on good quality paper. Attach photo here 45mm high x 35mm wide Section 1 - Application Details What class or classes of work are you applying for: (you may tick Private investigator employee Confidential document destruction agent employee Security technician employee Personal guard employee more than one) Security consultant employee Property guard employee Crowd controller employee Repossession agent employee te: crowd controllers and private investigators have special responsibilities. For more information go to Have you undertaken the relevant training requirements namely NQA unit standard 27360, NQA unit standard and NQA unit standard 27364? Please note that some people are exempt from the requirement to hold NQA unit standard See here for more details (Please tick to confirm ) you are required to attach a copy of your training certification to this application. you must undertake the required training. However you can apply for a temporary certificate of approval to allow you to work while you complete the training. A temporary certificate is valid for three months. The following permit classes Private Investigator, Security Technician and Security Consultant are of a specialised nature and you must provide suitable evidence that you are: competent or trained receiving appropriate training The evidence of competency for Private Investigator, Security Technician and Security Consultant can be: letter from previous/current employer as to work history letter from previous/current employer that you are an apprentice qualifications gained member of the N Institute of Professional Investigators (NIPI) If you need to work for a licence holder or as a crowd controller employee whilst your application is being processed, you may be eligible for a temporary certificate of approval. Do you wish to apply for a temporary certificate of approval (Please tick to confirm ) Please note a temporary certificate of approval is an additional $20.00 (in addition to your application fee). If you have previously held a licence or a certificate of approval under the Private Investigators and Security Guards Act 1974 or the Private Security Personnel and Private Investigators Act 2010, provide your licence number or certificate number here: Page 2 For more information visit PSPLA 02/15 - A

3 Section 2 Personal Details What is your name? First name(s) Middle name(s) Last name(s) Are you known by, or have you ever been known by another name? (Please tick to confirm ) If yes please supply details, if no leave this box blank and move on to the next question. Other name 1 First name(s) Middle name(s) Last name(s) Other name 2 First name(s) Middle name(s) Last name(s) Date of Birth / / (day / month / year) What is your gender? (Please tick to confirm ) Male Female Are you currently employed? (Please tick to confirm ) If yes, please supply further details below, if no please move to the residential address question. What is your occupation? Who are you employed by? If you are employed by several employers please list their names here Page 3 For more information visit PSPLA 02/15 - A

4 Section 2 Personal Details (contd) What is your residential address? Street Suburb Postcode City / town State (if outside of N) Country Do you have a different postal address? (Please tick to confirm ) If yes what is your postal address: Street / PO Box Suburb Postcode City / town State (if outside of N) Country How can we contact you? Daytime contact number ( ) Other contact number ( ) Mobile number Fax number ( ) address Section 3 Photo Identification Details Photo identification is required to verify your identity when you pick up your Certificate of Approval and ID badge. Please provide details of your Passport, New ealand Driver s Licence, HAN 18+ card or New ealand Firearms Licence below: or Passport number Nationality as shown on passport Passport expiry date / / (day / month / year) Date issued / / (day / month / year) New ealand Driver s Licence number Driver s Licence expiry date / / (day / month / year) Driver s Licence version number or Other identification type HAN 18+ N Firearms licence Other identification number Page 4 For more information visit PSPLA 02/15 - A

5 Section 4 Disqualification Criteria You are not eligible to hold a certificate of approval if disqualification criteria apply to you. Section 62 of the Private Security Personnel and Private Investigators Act 2010 lists certain grounds that may disqualify you from being granted a certificate of approval. If you meet any of the grounds of disqualification listed below, you will be able to make a statement about your character, circumstances or background. The Licensing Authority may still grant your application, but only if the Authority is satisfied that you are suitable to work in the class or classes of work to which the application relates. Please note that no refund is payable if your application is unsuccessful. You can find more information at Please answer each individual question below. (Please tick to confirm ) Have you ever been convicted of a specified offence as defined in section 4 of the Criminal Records (Clean Slate) Act 2004? In the last 7 years, have you been convicted by a New ealand court of an offence under the Arms Act 1983? In the last 7 years, have you been convicted by a New ealand court of an offence under sections 216H to 216J of the Crimes Act 1961? In the last 7 years, have you ever been convicted by a New ealand court of an offence under sections 10, 11, 13, 16, 19, 21, 24, 47F, or 47J of the Fair Trading Act 1986? In the last 7 years, have you ever been convicted by a New ealand court of an offence under section 103(1) of the Credit Contracts and Consumer Finance Act 2003 that involves a breach of any provision of Part 3A of that Act? In the last 7 years, have you ever been convicted by a New ealand court of an offence under section 8 or 25 of the Harassment Act 1997? In the last 7 years, have you ever been convicted by a New ealand court of an offence under section 6 of the Misuse of Drugs Act 1975 in relation to quantities deemed for supply of a Class A, B or C controlled drug or drugs? In the last 7 years, have you ever been convicted by a New ealand court of an offence of dishonesty, as defined in section 4 of the Private Security Personnel and Private Investigators Act 2010 ( offence of dishonesty )? In the last 7 years, have you ever been convicted by a New ealand court of an offence of violence, as defined in section 4 of the Private Security Personnel and Private Investigators Act 2010 ( offence of violence )? In the last 7 years, have you ever been convicted by a New ealand court of an offence under sections 16, 34 or 52 of the Private Investigators and Security Guards Act 1974? Have you ever been disqualified from driving for an indefinite period and ordered to attend an assessment centre under section 65 of the Land Transport Act 1998, or an earlier equivalent provision? Have you ever been ordered by a New ealand court to be imprisoned following conviction for an offence and that conviction or order has not been quashed on appeal? In the last 7 years, have you ever been convicted by a New ealand court of an offence under the Private Security Personnel and Private Investigators Act 2010 or Private Investigators and Security Guards Act 1974 for working without a licence or certificate or approval or employing or engaging a person without a certificate of approval? In the last 7 years, have you had a licence or certificate of approval cancelled under the Private Security Personnel and Private Investigators Act 2010 or the Private Investigators and Security Guards Act 1974? Do you hold a licence or certificate of approval that has been suspended? Page 5 For more information visit PSPLA 02/15 - A

6 Section 4 Disqualification Criteria (contd) Have you ever had an order made in relation to you under section 34(1)(b) of the Criminal Procedure (Mentally Impaired Persons) Act 2003, section 118 of the Criminal Justice Act 1985, or section 39J of the Criminal Justice Act 1954 (being an order imposed, instead of passing sentence, that you be treated or cared for in a manner that your mental impairment requires, either in your own interest, or the safety of the public, or for the safety of the public, or for the safety or a person or class of person)? Are you currently subject to a court order that requires you to be detained in a hospital because of a mental condition? If you have answered yes to a ground for disqualification you can provide further information to support your application (for example, evidence of your character, circumstances, or background). If you need extra space please attach a separate sheet to this application. Have you met any requirements prescribed in regulations made under section 114(h)(i) of the Private Security Personnel and Private Investigators Act 2010, (which relate to the competency, knowledge, and skills required for licences and certificates of approval)? [You must provide proof of meeting those requirements with this application.] If you have completed any of the training requirements set out in section 114(1)(h) of the Private Security Personnel and Private Investigators Act 2010, please provide details below: If you need extra space please attach a separate sheet to this application. Section 5 Overseas Mental Health Orders and Convictions Section 46 of the Private Security Personnel and Private Investigators Act 2010 also requires that you specify if you have had an overseas mental health order or conviction. You may provide further information to support your application (for example, information about your character, circumstances, or background) if you have specified a conviction or order as follows: (Please tick to confirm ) Have you ever had an order imposed in relation to you by any court or tribunal outside of New ealand, instead of passing sentence, that you be treated or cared for in relation to your mental impairment? Have you ever been convicted of an offence outside of New ealand? Page 6 For more information visit PSPLA 02/15 - A

7 Section 5 Overseas Mental Health Orders and Convictions (contd) Please provide further information below: If you need extra space please attach a separate sheet to this application. Section 6 Certificate and Badge Collection Which branch of N Post would you prefer to pick up your certificate of approval and ID badge from (should your application be successful?) a list of branches can be found at Location Section 7 Consent and Certification I consent to the Ministry of Justice undertaking a criminal history check using the information contained in my application. I certify that the above particulars are true and correct. Name Date / / (day / month / year) Signature Section 8 Checklist Before you submit this form please check that: (Please tick to confirm ) You have answered every applicable question; You have attached your photograph; You have signed and dated this form; and You have included a cheque totalling the amount of the application. Please mail this completed form with photograph and cheque to: Private Security Personnel Licensing Authority DX Box: SX Wellington Page 7 For more information visit PSPLA 02/15 - A

8 Legislative Extract - Definitions of Certificate of Approval classes of business Meaning of private investigator employee In this Act, private investigator employee means an individual who in the course of his or her employment, or engagement as a contractor, by a private investigator seeks, or obtains for any person or supplies to any person, any information specified in section 5(2). Meaning of security technician employee In this Act, security technician employee means an individual who in the course of his or her employment, or engagement as a contractor, by a security technician (a) installs or repairs on, or removes from, any part of any premises that are not owned or occupied by the security technician, the security technician s firm, or any of the security technician s partners (i) a burglar alarm or similar warning device intended to immediately alert a person or persons to the presence of a person or persons in a particular place; or (ii) a locking device for a safe or a strongroom; or (b) installs, operates, causes to be operated, or repairs, on or in, or removes from, any premises or other place not owned or occupied by the security technician, the security technician s firm, or any of the security technician s partners any camera or similar device for the purpose of detecting the commission of any offence by any person. Meaning of security consultant employee In this Act, security consultant employee means an individual who in the course of his or her employment, or engagement as a contractor, by a security consultant (a) enters any premises that are not owned or occupied by the security consultant, the security consultant s firm, or any of the security consultant s partners for the purpose of selling or attempting to sell any device of the kind referred to in section 6(1)(a) or (b); or (b) enters any premises that are not owned or occupied by the security consultant, the security consultant s firm, or any of the security consultant s partners for the purpose of advising the owner or occupier of the premises on the desirability of having installed on the premises any, or any further, such device; or (c) enters any premises that are not owned or occupied by the security consultant, the security consultant s firm, or any of the security consultant s partners for the purpose of advising the owner or occupier of the premises on the desirability of having guarded the premises or any other property that may from time to time be on the premises or dispatched from the premises. Meaning of repossession agent employee In this Act, repossession employee (a) means an individual who in the course of his or her employment, or engagement as a contractor, by a repossession agent or a creditor repossesses, or holds himself or herself out as being authorised to repossess, consumer goods; and (b) includes a creditor who carries out a repossession himself or herself, regardless of whether the creditor is, in fact, an employee. Meaning of confidential document destruction agent employee In this Act, confidential document destruction agent employee means an individual who in the course of his or her employment, or engagement as a contractor, by a confidential document destruction agent (a) collects, for destruction, documents identified as being of a confidential nature; and (b) destroys those documents. Meaning of property guard employee In this Act, property guard employee means an individual who in the course of his or her employment, or engagement as a contractor, by a property guard (a) guards, elsewhere than on premises owned or occupied by the property guard, the property guard s firm, or any of the property guard s partners, any real or personal property belonging to another person; or (b) monitors in real time, elsewhere than on premises owned or occupied by the property guard, the property guard s firm, or any of the property guard s partners, any of the following: (i) a burglar alarm or similar warning device intended to immediately alert a person or persons to the presence of a person or persons in a particular place: (ii) a camera or similar device; or (c) responds to any device in paragraph (b)(i) or (ii) that has been activated and that is on any part of any premises that are not owned or occupied by the property guard, the property guard s firm, or any of the property guard s partners. Meaning of personal guard employee In this Act, personal guard employee means an individual who in the course of his or her employment, or engagement as a contractor, by a personal guard (a) guards a specific person or persons; or (b) guards a specific person or persons and keeps order at any place (not being premises or a conveyance licensed under the Sale of Liquor Act 1989) where the person or persons being guarded may be. Meaning of crowd controller employee (1) In this Act, crowd controller employee means an individual who in the course of his or her employment, or engagement as a contractor, by a crowd controller or other person (a) screens entry to a place (other than simply ensuring that admission has been paid or that those entering have appropriate invitations or passes): (b) keeps order in a place (more than merely being expected to draw the attention of others to behaviour that is inappropriate or threatens to become inappropriate): (c) removes any person from a place. (2) A person is not a crowd controller employee if (a) he or she is not employed or engaged primarily to do work of a kind specified in subsection (1)(a), (b), or (c), but performs that work incidentally to the principal work he or she performs; or (b) he or she does the work specified in section 18(b) and no other work of a kind specified in subsection (1)(a), (b), or (c). Page 8 For more information visit PSPLA 02/15 - A

Application for a Company Licence

Application for a Company Licence Private Security Personnel Licensing Authority For more information visit www.pspla.govt.nz Application for a Company Licence Under the Private Security Personnel and Private Investigators Act 2010 1 What

More information

APPLICATION FOR A LICENCE Security & Related Activities (Control) Act 1996

APPLICATION FOR A LICENCE Security & Related Activities (Control) Act 1996 WESTERN AUSTRALIA POLICE APPLICATION FOR A LICENCE Security & Related Activities (Control) Act 1996 Instructions to applicants follow all of these steps to complete your application You must carefully

More information

Application for a real estate salesperson registration certificate

Application for a real estate salesperson registration certificate New registration application Form 3 1 Notes Application for a real estate salesperson registration certificate Property Occupations Act 2014 This form is effective from 1 December 2014 ABN: 13 846 673

More information

Fair Trading will aim to make a decision on your application within 6 weeks after receiving all relevant information from you and other agencies.

Fair Trading will aim to make a decision on your application within 6 weeks after receiving all relevant information from you and other agencies. Application No. OFFICE USE ONLY Form PL-21 ABN 81 913 830 179 Property, Stock and Business Agents Act 2002 Application for a CERTIFICATE OF REGISTRATION FEE: $129.00 - applicable from 1 July 2015 to 30

More information

Fit and proper person form

Fit and proper person form Fit and proper person form Last updated: 9 March 2015 About this form To hold any maritime document(s), you are required to be a fit and proper person. This applies at all times while the documents are

More information

Application to renew an interstate Licence to Perform High Risk Work

Application to renew an interstate Licence to Perform High Risk Work Workplace Health and Safety Queensland FORM 97 Application to renew an interstate Licence to Perform High Risk Work V1.7.14 This form is only to be completed for high risk work licences that were issued

More information

LAST NAME GIVEN NAME(S) DATE CEASED / / LAST NAME GIVEN NAME(S) DATE CEASED / /

LAST NAME GIVEN NAME(S) DATE CEASED / / LAST NAME GIVEN NAME(S) DATE CEASED / / Application by an INDIVIDUAL FOR A NSW SECURITY LICENCE under the Mutual Recognition Act 1992 and/or Trans-Tasman Mutual Recognition Act 1997 OFFICE USE ONLY Application No: - Receipt No: - Trim No: To

More information

APPLICATION FOR A LICENCE Security & Related Activities (Control) Act 1996

APPLICATION FOR A LICENCE Security & Related Activities (Control) Act 1996 Security & Related Activities (Control) Act 1996 Instructions to applicants follow all of these steps to complete your application You must carefully complete all sections and attach all required documents.

More information

APPLICATION FOR NEW CERTIFICATE OF COMPETENCE

APPLICATION FOR NEW CERTIFICATE OF COMPETENCE APPLICATION FOR NEW CERTIFICATE OF COMPETENCE This is an application form for a certificate of competence under the Health and Safety in Employment (Mining Operations and Quarrying Operations) Regulations

More information

Agents financial administration Form 4

Agents financial administration Form 4 Agents financial administration Form 4 Collection agent application for authority to open a trust account Agents Financial Administration Act 2014 Debt Collectors (Field Agents and Collection Agents) Act

More information

Mutual Recognition. Who can apply? Build better.

Mutual Recognition. Who can apply? Build better. Build better. Mutual Recognition Mutual Recognition is a process whereby an individual who holds a licence in one state, territory or New Zealand is entitled to be licensed in another state, territory

More information

Application to register a change of name (adult 18 years or over)

Application to register a change of name (adult 18 years or over) Government of Western Australia Department of the Attorney General Registry of Births, Deaths & Marriages BDM400 Application to register a change of name (adult 18 years or over) Eligibility You must be

More information

Registration as a Physiotherapist within the Special Purpose Scope of Practice: Postgraduate Physiotherapy Student

Registration as a Physiotherapist within the Special Purpose Scope of Practice: Postgraduate Physiotherapy Student APPLICATION FORM Registration as a Physiotherapist within the Special Purpose Scope of Practice: Postgraduate Physiotherapy Student Please complete this Application Form with reference to the Application

More information

Application to register a change of name (adult 18+ years)

Application to register a change of name (adult 18+ years) Application to register a change of name (adult 18+ years) July 2014 Recognising the significance of life events Important information about your change of name application If you require access to a translation

More information

Application for registration in New Zealand Part B: This form is to be accompanied by Part A [checklist] and all documents required on checklist

Application for registration in New Zealand Part B: This form is to be accompanied by Part A [checklist] and all documents required on checklist Application for registration in New Zealand Part B: This form is to be accompanied by Part A [checklist] and all documents required on checklist REG1 October 2015 For office use only Registration no: PO

More information

Overseas: NOTES. Application for an Australian Passport. Your checklist. Keep your passport safe at all times.

Overseas: NOTES. Application for an Australian Passport. Your checklist. Keep your passport safe at all times. Application for an Australian Passport Overseas: NOTES Who can apply for an Australian passport? All Australian citizens can apply if you have any questions or doubts about your Australian citizenship,

More information

APPLICATION FOR. License Fee Only. Non- NZTA

APPLICATION FOR. License Fee Only. Non- NZTA C4:08-15 NEW ZEALAND THOROUGHBRED RACING INC PO Box 38386, WMC Telephone: (04) 576 6240 Facsimile: (04) 568 8866 Web: www.nzracing.co.nz Email: licensing@nzracing.co.nz APPLICATION FOR Non- NZTA License

More information

Application for a Scrap Metal Licence

Application for a Scrap Metal Licence Application for a Scrap Metal Licence SECTION 1. TYPE OF APPLICATION (For all applicants) Please indicate the type of licence you are applying for (please tick): A site licence A collector s licence Are

More information

APPLICATION FOR REGISTRATION AS A BUILDING PRACTITIONER CERTIFYING ENGINEER - INDIVIDUAL

APPLICATION FOR REGISTRATION AS A BUILDING PRACTITIONER CERTIFYING ENGINEER - INDIVIDUAL NORTHERN TERRITORY BUILDING PRACTITIONERS BOARD APPLICATION FOR REGISTRATION AS A BUILDING PRACTITIONER CERTIFYING ENGINEER - INDIVIDUAL SECTION 1 PERSONAL DETAILS FAMILY NAME (Surname) GIVEN NAME (First

More information

Individual Construction Occupations (Licensing) Act 2004, s128 and s17

Individual Construction Occupations (Licensing) Act 2004, s128 and s17 Application to renew/issue an expired licence Construction Occupation licence Individual Construction Occupations (Licensing) Act 2004, s128 and s17 This form is to be used for individuals to: renew a

More information

Early release of super on compassionate grounds How to make a claim

Early release of super on compassionate grounds How to make a claim Early release of super on compassionate grounds How to make a claim Please note if you have ceased work due to sickness or injury, call us on 13 11 84 before proceeding. Am I eligible to make a claim?

More information

Application for Construction Occupation Licence Individual Plumber Construction Occupations (Licensing) Act 2004, s128 and s17

Application for Construction Occupation Licence Individual Plumber Construction Occupations (Licensing) Act 2004, s128 and s17 Application for Construction Occupation Licence Individual Plumber Construction Occupations (Licensing) Act 2004, s128 and s17 This approved form is to be used for individuals applying under the Construction

More information

Licence Application Form COMPANY

Licence Application Form COMPANY Licence Application Form COMPANY Completing this form Use BLACK pen only Print clearly in BLOCK LETTERS DO T use correction fluid any amendments should be crossed out and initialled 1. COMPANY DETAILS

More information

Application for Accreditation by Testing

Application for Accreditation by Testing Application for Accreditation by Testing OFFICE USE ONLY AUS NZ OS Please use blue or black ball point pen to complete this form. Please print in BLOCK LETTERS. NAATI Number: (if known) Part 1 Please provide

More information

CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION

CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION PLEASE READ THESE INSTRUCTIONS CAREFULLY This is an interactive

More information

Entertainment Industry Accreditation Application

Entertainment Industry Accreditation Application OFFICE USE ONLY Client no.: Date received: / / Application no.: INZ 1197 Entertainment Industry Accreditation Application Under Specific Purpose or Event Instructions Entertainment industry accreditation

More information

Payment of unclaimed superannuation money

Payment of unclaimed superannuation money Instructions and form for super fund members Payment of unclaimed superannuation money How to complete your Application for payment of unclaimed superannuation money individual. For information about unclaimed

More information

Owner Builder permit. Owner builder application. Company application. Lease agreements. Owner builder course. Build better.

Owner Builder permit. Owner builder application. Company application. Lease agreements. Owner builder course. Build better. Build better. Owner Builder permit Under the Queensland Building and Construction Commission Act 1991 you must obtain an Owner Builder permit before carrying out building work with a value of $11,000 or

More information

Retirement Lump Sum application information (Issued under sections 27, 149, 150, 151 and 213 of the Veterans Support Act 2014)

Retirement Lump Sum application information (Issued under sections 27, 149, 150, 151 and 213 of the Veterans Support Act 2014) Retirement Lump Sum application information (Issued under sections 27, 149, 150, 151 and 213 of the Act 2014) Please read before you complete this form This application form is for veterans reaching the

More information

APPLICATION FOR A HIGH RISK WORK LICENCE Work Health and Safety Act 2011

APPLICATION FOR A HIGH RISK WORK LICENCE Work Health and Safety Act 2011 APPLICATION FOR A HIGH RISK WORK LICENCE Work Health and Safety Act 2011 PURPOSE This form is to be used to apply for a high risk work licence under the Work Health and Safety Act 2011 (the Act). You can

More information

Property Management Services Bill. Contents

Property Management Services Bill. Contents C2717 Property Management Services Bill Contents Clause Page Part 1 Preliminary 1. Short title and commencement... C2727 2. Interpretation... C2727 3. Property management services... C2733 4. Disciplinary

More information

CHC30113 Certificate III in Early Childhood Education and Care

CHC30113 Certificate III in Early Childhood Education and Care ENROLMENT APPLICATION FORM CHC30113 Certificate III in Early Childhood Education and Care About this application Use this Enrolment Application to apply for enrolment in the CHC30113 Certificate III in

More information

BERMUDA PRIVATE INVESTIGATORS AND SECURITY GUARDS ACT 1974 1974 : 78

BERMUDA PRIVATE INVESTIGATORS AND SECURITY GUARDS ACT 1974 1974 : 78 QUO FA T A F U E R N T BERMUDA PRIVATE INVESTIGATORS AND SECURITY GUARDS ACT 1974 1974 : 78 TABLE OF CONTENTS 1 2 3 4 4A 5 6 6A 7 8 9 9A 10 11 12 13 14 15 16 17 18 Interpretation Application of the Act

More information

Renewal of registration Building surveying contractor (individual) Form 63

Renewal of registration Building surveying contractor (individual) Form 63 Government of Western Australia Department of Commerce Renewal of registration Building surveying contractor (individual) Form 63 Use of this form This form is to be used by building surveyors who are

More information

APPLICATION FORM VET FEE HELP (VFH)

APPLICATION FORM VET FEE HELP (VFH) APPLICATION FORM VET FEE HELP (VFH) (AUSTRALIAN CITIZEN OR PERMANENT HUMANITARIAN VISA HOLDER RESIDING IN AUSTRALIA, MUST BE 18 YEARS OF AGE TO ENROL) PERSONAL DETAILS (PLEASE FILL USING CAPITAL LETTERS)

More information

THE PRIVATE SECURITY SERVICE BILL (No. VI of 2004) Explanatory Memorandum

THE PRIVATE SECURITY SERVICE BILL (No. VI of 2004) Explanatory Memorandum THE PRIVATE SECURITY SERVICE BILL (No. VI of 2004) Explanatory Memorandum The object of this Bill is to provide for the licensing of private security services, the registration of security guards, the

More information

Casino Control Act 2006

Casino Control Act 2006 Australian Capital Territory A2006-2 Republication No 13 Effective: 14 October 2015 Republication date: 14 October 2015 Last amendment made by A2015-33 Authorised by the ACT Parliamentary Counsel About

More information

How To Get A Job In A Police Station

How To Get A Job In A Police Station Queensland Working with Children (Risk Management and Screening) Act 2000 Current as at 2 January 2015 Information about this reprint This reprint shows the legislation current as at the date on the cover

More information

Application for Security Officer and/or Crowd Controller Licence

Application for Security Officer and/or Crowd Controller Licence Application for Security Officer and/or Crowd Controller Licence Private Security Act Please print in block letters. All questions must be answered and full particulars provided. If there is insufficient

More information

Three year term. (One licence category includes non-refundable application fee of $144.60 ) $1242.60 $2329.60 $144.60

Three year term. (One licence category includes non-refundable application fee of $144.60 ) $1242.60 $2329.60 $144.60 New licence application Form 1 1 Notes Application for an individual s licence Real estate agent, property auctioneer, resident letting agent, motor dealer, chattel auctioneer Property Occupations Act

More information

GETTING INVOLVED? Occasional Helper (OH) Form (England and Wales) scouts.org.uk/appointment D D M M Y Y M F D D M M Y Y

GETTING INVOLVED? Occasional Helper (OH) Form (England and Wales) scouts.org.uk/appointment D D M M Y Y M F D D M M Y Y GETTING INVOLVED? Occasional Helper (OH) Form (England and Wales) You must Use CAPITAL LETTERS when completing the form. Write clearly and insert only one character in each box. Mark choices in the box

More information

Application for Approval to Provide Legal Aid Services_VERSION 2 Page 1 / 11

Application for Approval to Provide Legal Aid Services_VERSION 2 Page 1 / 11 Application for Approval to Provide Legal Aid Services Part 1 Please use this form if you are seeking approval as a provider of legal aid services, (lead provider, supervised provider or an employment

More information

Application for Registration as an Agent s Representative

Application for Registration as an Agent s Representative Application for Registration as an Agent s Representative Agents Licensing Act Please print in block letters. If there is insufficient space, attach extra sheets. All questions must be answered and full

More information

APPLICATION GUIDELINES Teacher registration

APPLICATION GUIDELINES Teacher registration APPLICATION GUIDELINES Teacher registration July 2013 GUIDELINES to completing the Application for Teacher Registration It is a legal requirement under the Education (Queensland College of Teachers) Act

More information

Application for adoption information: Relative or guardian of adopted person who is deceased or does not have capacity

Application for adoption information: Relative or guardian of adopted person who is deceased or does not have capacity The purpose of the application for adoption information: is deceased or does not have capacity form This form is for use by a relative or guardian of an adult adopted person to apply for adoption information

More information

International Student Application Form

International Student Application Form Please complete this form and attach certified copies of all documents required. If these documents are not provided, your application will be incomplete. Your application cannot be considered without

More information

Partnership Support Form for Residence

Partnership Support Form for Residence OFFICE USE ONLY Client no.: Date received: Application no.: March 2015 INZ 1178 Partnership Support Form for Residence For applications under the Partnership Category of Residence Instructions tes for

More information

Form 11 Application for electrical work licence/permit (other than apprentice)

Form 11 Application for electrical work licence/permit (other than apprentice) Electrical Safety Office Form 11 Application for electrical work licence/permit (other than apprentice) V15.06-2014 Electrical Safety Act 2002 If you are applying for an additional electrical work training

More information

Middlesex University Application Form

Middlesex University Application Form Middlesex University Application Form OFFICE USE ONLY Regional ID/Agency Code: MISIS Student Number: This form is to be used for Direct applications only Full Time Undergraduate applications should be

More information

Casino, Liquor and Gaming Control Authority Act 2007 No 91

Casino, Liquor and Gaming Control Authority Act 2007 No 91 New South Wales Casino, Liquor and Gaming Control Authority Act 2007 No 91 Contents Part 1 Part 2 Preliminary Page 1 Name of Act 2 2 Commencement 2 3 Definitions 2 4 Meaning of gaming and liquor legislation

More information

Child. Application for an Australian Passport. Your checklist

Child. Application for an Australian Passport. Your checklist Application for an Australian Passport Child Appointments Only certain applicants should lodge their forms at a passport office in Australia. Appointments are essential. See notes for details. Protect

More information

REQUEST FOR WITHDRAWAL

REQUEST FOR WITHDRAWAL REQUEST FOR WITHDRAWAL If you need help For assistance call NGS Super Customer Service Team on 1300 133 177. Step 1. Complete your personal details Please print in black or blue pen, in uppercase, one

More information

PLEASE READ BEFORE COMPLETING YOUR APPLICATION

PLEASE READ BEFORE COMPLETING YOUR APPLICATION Application to become a Licensed London Private Hire Operator Dear Applicant PLEASE READ BEFORE COMPLETIG OUR APPLICATIO Thank you for applying to become a Licensed London Private Hire Operator. Enclosed

More information

This standard involves verification of identity; nationality and immigration status; employment history (past 3 years) and criminal record.

This standard involves verification of identity; nationality and immigration status; employment history (past 3 years) and criminal record. HUMAN RESOURCES, SECURITY AND FACILITIES DIVISION BASELINE PERSONNEL SECURITY STANDARD All government departments are required to ensure that any personnel employed/engaged by them to work in their offices

More information

APPLICATION FOR LANDLORD REGISTRATION

APPLICATION FOR LANDLORD REGISTRATION APPLICATION FOR LANDLORD REGISTRATION Under the Antisocial Behaviour etc (Scotland) Act 2004 You can use this form apply for registration as a landlord or landlord s agent with Orkney Islands Council.

More information

Application for a Security Firm licence

Application for a Security Firm licence Private Security Act Please print in block letters 1. Type of application How will the business be structured? Natural person (Sections 2, 3, 9, 13, 14 and 15 of application) Natural persons in partnership

More information

UC s lecture theatre Course Preferences Research Degree Application Form Tick in the box below to indicate your choice of course Doctor of Philosophy (PhD) in Management Doctor of Philosophy (PhD)

More information

If this is an application for a Health Professional listed in Part A or Part B of Schedule 2 in the Principal Regulations please tick this box

If this is an application for a Health Professional listed in Part A or Part B of Schedule 2 in the Principal Regulations please tick this box CSEP002/15 Critical Skills Employment Permit Application This form should be used by either the Person who has made the offer of employment or the Foreign National, the subject of that offer of employment,

More information

Visitor Visa Application

Visitor Visa Application OFFICE USE ONLY Client no.: Date received: / / Application no.: April 2016 INZ 1017 Visitor Visa Application for a temporary stay in New Zealand Apply for your visa online it s faster & easier The fastest

More information

IRD number application - non-resident/offshore individual

IRD number application - non-resident/offshore individual IR742 February 2016 IRD number application - non-resident/offshore individual For full details go to www.ird.govt.nz (search keyword: offshore). Only use this form if you're a non-resident or offshore

More information

Application from a Resident or Former Resident Visa Holder

Application from a Resident or Former Resident Visa Holder OFFICE USE ONL Client no.: ate received: / / Application no.: March 2015 INZ 1175 Application from a Resident or Former Resident Visa Holder for a permanent resident visa, second or subsequent resident

More information

The Private Investigators and Security Guards Regulations, 2000

The Private Investigators and Security Guards Regulations, 2000 1 AND SECURITY GUARDS, 2000 P-26.01 REG 1 The Private Investigators and Security Guards Regulations, 2000 being Chapter P-26.01 Reg 1 (effective October 1, 2000) as amended by Saskatchewan Regulations

More information

CRIMINAL HISTORY CHECK APPLICATION

CRIMINAL HISTORY CHECK APPLICATION NORTHERN TERRITORY POLICE SAFE NT Phone 1800 723 368 (1800 SAFENT) Office Hours 8 30am 4 30pm Monday Thursday 9 30am 5 30pm Friday CRIMINAL HISTORY CHECK APPLICATION PF095 06/12 C APPLICATION FOR CRIMINAL

More information

International Application

International Application International Application Personal Details Family Name: Given Names: Date of Birth (DDMMYYYY): Gender: Male Female Place of Birth: Nationality: Language(s) spoken at home: Passport Number: Passport Expiry

More information

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care.

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care. Aged Care Education and Training Incentive Programme COMMENCEMENT PAYMENT This application form is to be completed by eligible aged care workers who have enrolled and commenced studies to enhance their

More information

Early Learning Payment Application

Early Learning Payment Application If you need help with this form call us on % 0800 559 009. About the Early Learning Payment What you need to do The Early Learning Payment contributes to the cost of early childhood education for families

More information

Application for registration as a Great Britain qualified pharmacist. Information and Application pack

Application for registration as a Great Britain qualified pharmacist. Information and Application pack Application for registration as a Great Britain qualified pharmacist Information and Application pack Application for registration of a pharmacist registered in Great Britain Registration Department 73

More information

Advance Retirement Suite Super Early Release Financial Hardship Application

Advance Retirement Suite Super Early Release Financial Hardship Application Advance Retirement Suite Super Early Release Financial Hardship Application Trustee: BT Funds Management Ltd (BTFM) ABN 63 002 916 458 AFSL 233724 GUIDE TO COMPLETING THIS FORM > > Use this form if you

More information

ARCHITECTS BOARD OF WESTERN AUSTRALIA

ARCHITECTS BOARD OF WESTERN AUSTRALIA ARCHITECTS BOARD OF WESTERN AUSTRALIA Application for Registration in Western Australia under Mutual Recognition Form 02 3 August 2015 Use of this Form This form is to be used by people wishing to apply

More information

Site Supervisor licence

Site Supervisor licence Build better. Site Supervisor licence QBCC s site supervisor licence was introduced to improve the standard and quality of supervision of building work and to provide an employee with a clear career path

More information

Employer Accreditation Application

Employer Accreditation Application OFFICE USE ONLY Client no.: Date received: / / Application no.: December 2015 INZ 1090 Employer Accreditation Application Under Talent (Accredited Employers) Work Instructions Information for employers

More information

APPLICATION FOR RETIREMENT (OLD AGE) AND INVALIDITY BENEFITS UNDER THE NATIONAL INSURANCE ACT OF 1965 JAMAICA

APPLICATION FOR RETIREMENT (OLD AGE) AND INVALIDITY BENEFITS UNDER THE NATIONAL INSURANCE ACT OF 1965 JAMAICA APPLICATION FOR RETIREMENT (OLD AGE) AND INVALIDITY BENEFITS UNDER THE NATIONAL INSURANCE ACT OF 1965 JAMAICA INSTRUCTIONS: I. This form is to be completed in BLOCK CAPITALS using black or blue ink pen;

More information

Form 20 Application for additional/change of qualified person for a contractor licence

Form 20 Application for additional/change of qualified person for a contractor licence Department of Justice and Attorney-General Electrical Safety Office Form 20 Application for additional/change of qualified person for a contractor licence V12.06-2014 Electrical Safety Act 2002 INSTRUCTIONS:

More information

The Hearing Aid Sales and Service Act

The Hearing Aid Sales and Service Act 1 HEARING AID SALES AND SERVICE c. H-2.01 The Hearing Aid Sales and Service Act being Chapter H-2.01 of The Statutes of Saskatchewan, 2001 (effective March 10, 2006) as amended by the Statutes of Saskatchewan,

More information

CHARTERED BANKER MBA. Application Form BANGOR BUSINESS SCHOOL - EXECUTIVE EDUCATION. www.charteredbankermba.co.uk

CHARTERED BANKER MBA. Application Form BANGOR BUSINESS SCHOOL - EXECUTIVE EDUCATION. www.charteredbankermba.co.uk BANGOR BUSINESS SCHOOL - EXECUTIVE EDUCATION CHARTERED BANKER MBA TM Application Form www.charteredbankermba.co.uk Notes on Completing the Application Form Please read the notes below before completing

More information

Form 18 Application for a Queensland electrical contractor licence

Form 18 Application for a Queensland electrical contractor licence Electrical Safety Office Form 18 Application for a Queensland electrical contractor licence V17.06-2014 Electrical Safety Act 2002 INSTRUCTIONS: Read the guidelines when completing this application form.

More information

A Hero rate or Zero fees at selected ATMs.

A Hero rate or Zero fees at selected ATMs. A Hero rate or Zero fees at selected ATMs. It s easy to open your Bankwest Hero Transaction account or Bankwest Zero Transaction account. Here s how: Now that you have downloaded the Bankwest Hero Transaction

More information

Sponsorship Form for Temporary Entry

Sponsorship Form for Temporary Entry OFFICE USE ONLY Client no.: Date received: Application no.: May 2016 INZ 1025 Sponsorship Form for Temporary Entry Supporting information for a visitor visa, work visa or student visa application Who can

More information

Farm Management Deposit (FMD) Application Form

Farm Management Deposit (FMD) Application Form Farm Management Deposit (FMD) Application Form INSTRUCTIONS FOR COMPLETING THE FARM MANAGEMENT DEPOSIT APPLICATION FORM Please read and complete sections A, B, D, E, F, H and I in BLOCK LETTERS using black

More information

Authorised Signatory Form

Authorised Signatory Form Form Complete this form: to give a person other than your adviser the authority to act on your existing margin lending facility in all matters as if they were you (including but not limited to increasing

More information

Education Services for Overseas Students Act 2000

Education Services for Overseas Students Act 2000 Education Services for Overseas Students Act 2000 Act No. 164 of 2000 as amended This compilation was prepared on 17 December 2008 taking into account amendments up to Act No. 144 of 2008 The text of any

More information

Section 2 Drivers a) If this is a renewal of Taxi/Private Hire car driver licence, please state your current licence number Driver No..

Section 2 Drivers a) If this is a renewal of Taxi/Private Hire car driver licence, please state your current licence number Driver No.. Aberdeenshire Council Application form in terms of Sections 10, 10(5) and 13 of the Civic Government (Scotland) Act 1982 Taxi / Private Hire Car Driver s Licence Taxi/Private Hire Car Vehicle Licence Six

More information

Tourist/Business Visitor Visa Application

Tourist/Business Visitor Visa Application OFFICE USE ONLY Client no.: received: / / Application no.: December 2015 INZ 1189 Tourist/Business Visitor Visa Application for use by people outside New Zealand intending a short stay Apply for your visa

More information

Medicare enrolment application

Medicare enrolment application Medicare enrolment application When to use this form Use this form if you are: a migrant living in Australia applying for permanent residency and living in Australia a visitor to Australia an Australian

More information

Application for Licence House in Multiple Occupation (HMO)

Application for Licence House in Multiple Occupation (HMO) Application for Licence House in Multiple Occupation (HMO) Please use the accompanying notes when completing this form. If you have more than one house in multiple occupation you will need to complete

More information

Job Application Form

Job Application Form Swan Mill Holdings Group Swan Mill Paper Co Ltd Penny Kennedy Castleview Enterprises Ltd Swantex Asia Post Applied for: Post Location: Job Application Form Interview #1 Date: Interview #2 Date: It is important

More information

Workers Compensation claim form

Workers Compensation claim form Form Workers Compensation claim form STOP - this form is available to be filled in electronically on the NT WorkSafe web site www.worksafe.nt.gov.au. Fill the form in electronically then save a copy to

More information

Application Form for the Special Support Service for Former Sawmill Workers Exposed to Pentachlorophenol (PCP)

Application Form for the Special Support Service for Former Sawmill Workers Exposed to Pentachlorophenol (PCP) Application Form for the Special Support Service for Former Sawmill Workers Exposed to Pentachlorophenol (PCP) Please read the factsheet General Information for Patients before completing this form Use

More information

Completion Certificate Application Form (New Zealand Degree Holders Only) [Effective 15 March 2016]

Completion Certificate Application Form (New Zealand Degree Holders Only) [Effective 15 March 2016] PERSONAL DETAILS [Please Print] Full Legal Name* Completion Certificate Application Form (New Zealand Degree Holders Only) [Effective 15 March 2016] Surname First Name Middle Name(s) Name Used Surname

More information

Registration and Licensure as a Pharmacy Technician

Registration and Licensure as a Pharmacy Technician Registration and Licensure as a Pharmacy Technician For applicants who are currently licensed to practise as a pharmacy technician in a Canadian jurisdiction outside New Brunswick. Please read all pages

More information

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care.

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care. Aged Care Education and Training Incentive Programme COMPLETION PAYMENT This application form is to be completed by applicants who have completed studies and have already received a commencement payment

More information

Selected Investment Funds (SIF) Plan and SIF Individual Savings Account (ISA) Additional Investment Form and Switch Form

Selected Investment Funds (SIF) Plan and SIF Individual Savings Account (ISA) Additional Investment Form and Switch Form HNBPST Selected Investment Funds (SIF) Plan and SIF Individual Savings Account (ISA) Additional Investment Form and Switch Form Notes on completing this form Please read the Selected Investment Funds Key

More information

How To Apply For A Student Visa To Australia

How To Apply For A Student Visa To Australia International student Foundation, Degree Transfer, TAFE, Undergraduate and Postgraduate Coursework Application form Representative/agent stamp (if applicable) If you are a permanent resident of Australia,

More information

REQUEST TO AMEND THE RECORD OF LANDING (IMM 1000), CONFIRMATION OF PERMANENT RESIDENCE (IMM 5292 or IMM 5688) OR VALID TEMPORARY RESIDENT DOCUMENTS

REQUEST TO AMEND THE RECORD OF LANDING (IMM 1000), CONFIRMATION OF PERMANENT RESIDENCE (IMM 5292 or IMM 5688) OR VALID TEMPORARY RESIDENT DOCUMENTS PROTECTED WHEN COMPLETED - B REQUEST TO AMEND THE RECORD OF LANDING (IMM 1000), CONFIRMATION OF PERMANENT RESIDENCE (IMM 5292 or IMM 5688) OR VALID TEMPORARY RESIDENT DOCUMENTS PAGE 1 OF 3 PART A - PERSONAL

More information

Registration and Licensure as a Pharmacy Technician

Registration and Licensure as a Pharmacy Technician Registration and Licensure as a Pharmacy Technician For applicants who have studied in Canada or worked in the field of pharmacy and are not licensed to practise as a pharmacy technician in any jurisdiction.

More information

Road Transport (Drink Driving) Legislation Amendment Bill 2010

Road Transport (Drink Driving) Legislation Amendment Bill 2010 00 THE LEGISLATIVE ASSEMBLY FOR THE AUSTRALIAN CAPITAL TERRITORY (As presented) (Minister for Transport) Road Transport (Drink Driving) Legislation Amendment Contents Page Part Preliminary Name of Act

More information

CLAIM FOR WORKERS COMPENSATION

CLAIM FOR WORKERS COMPENSATION CLAIM FOR WORKERS COMPENSATION Seafarers Rehabilitation and Compensation Act 1992 Information about claiming workers compensation In this document, all references to the employer mean the employer against

More information

(Chapter No. not allocated yet) SOCIAL SECURITY ORDINANCE

(Chapter No. not allocated yet) SOCIAL SECURITY ORDINANCE (Chapter No. not allocated yet) SOCIAL SECURITY ORDINANCE Non-authoritative Consolidated Text This is not an authoritative revised edition for the purposes of the Revised Edition of the Laws Ordinance;

More information

1. Applicant details. 2. Corporate applicant. Individual / Partner 1 Given names (do not abbreviate) Surname (include maiden name if married)

1. Applicant details. 2. Corporate applicant. Individual / Partner 1 Given names (do not abbreviate) Surname (include maiden name if married) Application for a Licence to Sell Poisons for Purposes other than Human Therapeutic Use (please refer to the Fact Sheet at the back of this form when completing this application) Are you: a sole trader

More information

Transit Visa Application

Transit Visa Application OFFICE USE ONLY Client no.: Date received: / / Application no.: November 2014 INZ 1019 Transit Visa Application Who can you include in your application? You can use this form to apply for a visa for a

More information