STEPS REQUIRED TO COMPLETE THE VOLUNTEER APPLICATION PROCESS for Operation Red Nose Ridge-Meadows

Transcription

1 STEPS REQUIRED TO COMPLETE THE VOLUNTEER APPLICATION PROCESS for Operation Red Nose RidgeMeadows Note to Volunteers: The clearance process takes several days and sometimes even several weeks so please submit your forms as early as possible. If you are uncertain of your availability but do intend to volunteer, just insert a question mark beside the calendar of dates and our Volunteer Director will be in touch later to confirm which dates work best for you. Please take your completed forms to one of the following locations with TWO pieces of governmentissued identification ONE of which must be photo identification (such as your Driver s License) and the SECOND piece may be a passport, Social Insurance card, Care Card, or other form of governmentissued identification: RCMP, Community Policing Office Harris Road, Pitt Meadows Hours of Operation: Monday to Friday 8:30 am to 4:30 pm Saturdays 10:00 am to 2:00 pm RCMP Detachment of Maple Ridge Haney Place, Maple Ridge Hours of Operation: Monday to Friday 8:00 am to 6:50 pm Saturdays 11:00 am to 3:00 pm The forms you are required to complete and submit are attached as follows: (1) Consent for Disclosure of Criminal Record Information (1 page) (2) 2014 Volunteer Application Form (2 pages) Although this form is not processed by the RCMP, it is required to help us coordinate volunteers and schedule the road teams. The Volunteer Director will contact you shortly after your clearance is complete. (3) Volunteer Duties overview (1 page) Thanks to the efforts of the RCMP at both the main detachment in Maple Ridge and at the Community Police Office in Pitt Meadows, Operation Red Nose volunteers are not required to submit a fee for this clearance. Also, for those volunteers who are cleared, your paperwork will be picked up by the Volunteer Director, unless you advise us otherwise. If any adverse items appear during the clearance checks, the volunteer will receive this information directly from staff at the CPO and it will be the volunteer s decision as to whether or not they still wish to pursue a volunteer role with Operation Red Nose. Background PacificSport Fraser Valley first introduced the seasonal designated driver program to the Pitt Meadows and Maple Ridge communities in As the host organization of the RidgeMeadows Operation Red Nose, now in its seventh year of service, PacificSport coordinates this service as its primary fundraiser. Donations and proceeds collected are directed to programs for regional high performance athletes and coaches, including travel and performance service grants. Thank you for supporting Operation Red Nose and your local athletes! DATES OF OPERATION RED NOSE SERVICE IN LOWER MAINLAND, BC: Nov 28, 29, Dec 5, 6, 12, 13, 19, 20 & 31

2 2014 VOLUNTEER APPLICATION FORM Volunteer No. : VOLUNTEER IDENTIFICATION Last name Surname at birth First Name Middle name Gender F M Civic number Street Apt. City Telephone (home) Telephone (cell) Telephone (work) Extension of birth (YYYY/MM/DD) Driver s Licence No. (File No.) Expiry date (YYYY/MM/DD) Do you have any licence restrictions? Mandatory for escort drivers to complete this section. DECLARATION Province issuing license Group/Company organizing your evening with Operation Red Nose, if applicable Use of a manual transmission? No ICBC Policy No (your license plate number) Expiry date (YYYY/MM/DD) (the date on the insurance decal attached to your license plate) I hereby volunteer my services for this year s campaign. I authorize any police service with jurisdiction over any or all parts of the province in which I reside to conduct a background check for any arrest, charge or conviction for a criminal offence for which I have not received rehabilitation or a pardon, and for any penal offence. I also authorize all police services to verify the validity of my driver s licence. I authorize all police services to conduct the said background check to ensure that I meet the Operation Red Nose selection criteria, as set out below : Yes No Incompatible offences if committed within the last five years Incompatible offences at all times Offences resulting in limited acceptance Selection Criteria Sex : prostitution (solicitation) Theft, fraud : Impersonation Violence : assault, trespassing at night, uttering threats, intimidation, Drugs : possession harassment, indecent telephone calls, mischief, arson causing damage to property, firearms (possession, omission) other criminal Other : breach of condition or probation, obstructing a peace officer, charges Sex : sexual assault or assault with a weapon, indecent acts, procuring, child pornography, corrupting children, bawdy house, rape Violence : kidnapping, attempted murder, homicide, aggravated assault, confinement, extortion, arson with disregard for human life, firearms (unauthorized use, trafficking) Theft, fraud : Theft, fraud (accepted as an escort driver during sanction) Theft, fraud : breaking and entering, robbery, corruption Driving : offence causing death or bodily harm Drugs : trafficking, importing, cultivating Other : arrest warrant Driving : flight, dangerous operation of a motor vehicule, refusal to comply with demand, operation while impaired (accepted as a navigator during prohibition), unpaid tickets (tickets must be paid before volunteering) I also authorize all police services with jurisdiction over any or all parts of the province in which I reside to forward the results of the background checks to the Operation Red Nose coordinator. In accordance with the relevant legislation, I agree to protect the confidentiality of all information and data disclosed to me about Operation Red Nose clients and volunteers. I certify that the information provided is accurate and complete. Furthermore, between the time I submit this form and the time I participate as a volunteer, I will inform Operation Red Nose of any changes that would result in my no longer meeting the selection criteria. I also agree to comply with the volunteer commitment set out on page 2 of this form, which I have read and understood. I do not wish to be contacted by Operation Red Nose for the 2015 campaign. By checking this box, I consent to the use of my name, image and likeness in the form of photographs for promotional purposes by Operation Red Nose, its partners, affiliates, agents, employees, representatives, licensees and assigns, without notification or compensation. Signature (mandatory) * This volunteer application form is valid for the 2014 campaign only. It is subject to approval and can be revoked at any time. Checked by (name and registration no.) Comments RESERVED FOR POLICE CHECK Meets the criteria yes no Cannot be a driver Cannot be an escort driver Cannot be a navigator Approved by (name) Reason ORN COMMITTEE Final result Accepted Refused The volunteer has provided a criminal record check Please return this form as soon as possible to :

3 VOLUNTEER COMMITMENT I agree to : take all necessary precautions to ensure the safety of my team and of Operation Red Nose clients by complying with, among others, the Highway Safety Code (speed limits, use of seatbelts, signage, parking, etc.). Operation Red Nose is not responsible for any ticket received during the course of my volunteer duties. comply with the Operation Red Nose code of ethics. Sobriety : I must not consume any alcohol on the day I work with Operation Red Nose. Confidentiality : All information about Operation Red Nose clients and volunteers that is disclosed to me will remain confidential and will not be used for any purpose other than to fulfill the mandate conferred upon me. I will also not discuss any details with other volunteers that could be used to identify a client or volunteer. Courtesy : I will show patience and courtesy toward clients at all times. Free service : Operation Red Nose is a free service. I will never solicit donations, but if clients wish to make a donation, I will thank them. Fatigue : Operation Red Nose volunteers must often deal with fatigue, and its effects at night must not be underestimated. Therefore, I will not overestimate my capabilities and, if necessary, I will take a nap before reporting for duty as an Operation Red Nose volunteer. Mutual respect : All Operation Red Nose volunteers, whether they work in the headquarters or on the road, deserve my full respect and consideration. return to Operation Red Nose all amounts given to me (donations, tips, gifts, etc.). If I do not honour my commitment, Operation Red Nose reserves the right to terminate my participation as a volunteer for the current and future campaigns. The decision of Operation Red Nose is final. VOLUNTEER DUTIES YOU ARE INTERESTED IN Please check the box of the duties that interest you. For office duties, please contact your local Operation Red Nose organization. Escort driver Person who escorts the driver and the navigator in his or her own vehicle. Must be 19 years of age or older Must have a valid class 5 driver s licence and a vehicule Please carefully complete the Driver s Licence and Insurance Company sections on the reverse. Operation Red Nose only provides insurance coverage to escort drivers whose vehicles are insured against damage. You must carry your proof of insurance and your driver s licence with you on the night of your shift with Operation Red Nose. Driver Person who drives the client s vehicle. Must be 21 years of age or older Must have a valid class 5 driver s licence Please indicate your driver s licence file number on the reverse. You must carry your driver s licence with you on the night of your shift with Operation Red Nose. Navigator Person who rides with the driver in the client s vehicle. Must be 19 years of age or older Driver s licence not mandatory, but indicating the number on the reverse will speed up the processing of your application. Have you participated in Operation Red Nose in the past? Yes No Calendar (November/December) Sun Mon Tue Wed Thu Fri Sat Please circle the dates you are available. A minimum of 48 hours is needed to process your application after it is received

4 VOLUNTEER DUTIES Operation Red Nose RidgeMeadows Thank you for your interest in volunteering with Operation Red Nose! Please indicate which volunteer duties you are interested in performing and submit with your volunteer application. Volunteer road team training is provided on each night of the 9 nights of Operation Red Nose service. Note: With the exception of Mascot and New Year s Eve, a typical volunteer shift is approximately 8:30pm 3:30am. ESCORT DRIVER (ROAD TEAM) Person who transports the driver & navigator in his or her own vehicle. Must be 19 years of age or older. Must have a valid class 5 driver s licence and a vehicle. Gas reimbursement is provided, however, the use of nonfuel efficient vehicles for escort purposes is strongly discouraged. Note: Operation Red Nose only provides insurance coverage to escort drivers whose vehicles are insured against damage. You must carry proof of insurance and your DL with you on the nights you volunteer. DRIVER (ROAD TEAM) Person who drives the client s vehicle. Must be 21 years of age or older. Must have a valid class 5 driver s licence. You must carry your DL with you on the nights that you volunteer. NAVIGATOR (ROAD TEAM) Person who accompanies the designated driver and the client in the client s car and manages client and trip information. Must be 19 years of age or older. Driver s licence not mandatory for this volunteer role MASCOT Person who wears the Rudy costume. Must be at least 5 8 tall. Please note: the Mascot also makes appearances at various community events in addition to the 9 nights of service. PHONE OPERATOR Person who answers incoming calls from the public at Headquarters and records all client/trip information on the call sheets. DISPATCHER Person who coordinates departure of road teams, and maintains contact during assignments via cell phone. HQ ASSISTANT Person who greets & signs in all the volunteers, assists with team formation and operates the switchboard during 9pm3am. HOSPITALITY Person who coordinates the refreshments for volunteers including food and beverage preparations and clean up duties.

5 To print this form, set your PRINT preferences to LEGAL. Royal Canadian Mounted Police Gendarmerie royale du Canada CONSENT FOR DISCLOSURE OF CRIMINAL RECORD INFORMATION PART 1 Surname Given name (1) Given name (2) IF COMPLETED MANUALLY, PLEASE PRINT Sex M F Tel. no. (incl. area code) of birth (yyyymmd) Place of birth Driver's licence no. Usual first name or alias Maiden name/any other Surname Previous address if less than 5 years at current address PART 2 Pursuant to Section 8(1) of the Privacy Act of Canada, I hereby authorize the Royal Canadian Mounted Police to disclose my personal information to: Full name Title Name of organization PART 3 WAIVER AND RELEASE: I hereby release and forever discharge Her Majesty the Queen in Right of Canada, the Royal Canadian Mounted Police, their members, employees, agents and assigns from any and all actions, causes of actions, claims and demands for damages, loss or injury, which may hereafter be sustained by myself, howsoever arising out of the above authorized disclosure of information and waive all rights thereto. PART 4 This consent is valid for a period of three months from the date of signature. Signed this day of Signature of applicant PART 5 Following is information contained in the records of the RCMP or records from other police forces accessible through computer queries and is based on a name and date of birth check only. **A record may or for the subject of this inquiry, positive identification and a certified criminal records check can only be obtained through a fingerprint check. This can be made with the submission of a complete set of fingerprints to: INFORMATION AND IDENTIFICATION SERVICES CANADIAN CRIMINAL RECORD INFORMATION SERVICES 1200 Vanier Parkway OTTAWA, ONTARIO K1A 0R2 YOUNG OFFENDER INFORMATION The Youth Criminal Justice Act/Young Offenders Act make it an offence to disclose young offender information. In cases where an adult's record contains young offender information or a young offender requests a copy of his/her criminal record, the criminal record information MUST be given to the requester. Individuals can disclose their own information, but even with consent the RCMP are not legally permitted to disclose young offender information. INSTRUCTION TO REQUESTERS: The following section contains varying degrees of police information. Confirm with the party identified in PART 2, the exact information they require. Choose the category which best symbolizes the information you are providing consent for the RCMP to disclose and place your initials in the appropriate INITIALS box. The party identified in PART 2 will be advised accordingly of negative checks. Checks resulting in possible "hits" for information identified in categories 1, 2 or 3 will require confirmation by the submission of fingerprints. You will be required to confirm that information through the checks stipulated in category 4, is your personal information. You may withdraw this consent prior to disclosure. No. Initials Category of Information for Disclosure FOR POLICE USE ONLY 1. Records of criminal convictions found in the Identification Data Bank attainable through the Canadian Police Information Centre (CPIC) for which a pardon has not been granted. RCMP: Make CPIC Criminal Record "LEVEL 1" Query ONLY. 2. Records of criminal convictions attainable through CPIC for which a pardon has not been granted plus records of outstanding criminal charges which the RCMP are aware of or indicated within the Investigative Data Bank of CPIC. RCMP: Make CPIC Criminal Record "LEVEL 1" Query AND a Persons CPIC Query. 3. Records of criminal convictions and summary of police information (including records of outstanding criminal charges which the RCMP are aware of or indicated within the Investigative Data Bank of CPIC) attainable through CPIC for which a pardon has not been granted plus records of discharges which have not been removed from the Identification Data Bank in accordance with the Criminal Records Act. This will include all charges regardless of disposition. RCMP: Make CPIC Criminal Record "LEVEL 2" Query AND a Persons CPIC Query. 4. Police information on computer systems (e.g. Police Information Retrieval System (PIRS), CPIC, PROS, PRIME, LEIP) and information through local police indices checks. This will include all information related to non convictions and all charges regardless of disposition. RCMP: Make Persons Queries on PIRS, CPIC, PROS, PRIME and LEIP. In view of the general nature of this information, confirm with requester this is in fact information pertaining to him/her. Requesters MUST confirm information which pertains to them prior to disclosure. If a discrepancy s, do not disclose this information. COMPLETED BY Member (signature) Reg. no. Unit RCMP GRC 3584e (200603)