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HOMESTAY APPLICATION PROCESS
1
Potential Host contacts Wintec Wintec will send out Application Pack
Potential Host complete all documentation, signs it and returns it with required ID and photographs
to Wintec via email
Wintec will enter relevant docs into required systems and undertake
required safety checks
A home visit and interview will be conducted while vetting is in progress
Once all results are received, a panel of Wintec Staff will approve or decline
application
If Successful, Homestay team will send through a homestay agreement for signing and return to Wintec for
countersigning
A copy of the countersigned agreement will be sent back to Host
and details entered into the Homestay placement database
RULES AND EXPECTATIONS FOR WINTEC HOMESTAY HOSTS
• A house key (and alarm code if required) so they canenter/exit the house whenever they like.
• A private bedroom for each student furnished with:
• Their own bed & appropriate bedding for therelevant season
• A place to store their clothing (i.e. dresser /wardrobe),
• A study table/desk and chair
• A heater during the Winter months or a Fan duringthe Summer.
• Students rooms must be cleared of family’s personalbelongings and the wardrobe (if available) must befree for the student to use.
• Access to shared facilities such as bathroom(s),lounge, dining room, television and laundry facilities
• Fresh weekly linen and towels for each student
• All meals are to be provided. During the week,students can be asked to make their own lunchor, if available, choose to take left overs to Wintec.
• Meals should contain a variety of vegetables withfruit readily available. It is unacceptable for hosts torequest additional payment from students for areasonable amount of fruit and vegetables.
• If you take your student out for lunch or dinner(to a restaurant or take out etc) it should be treatedas a meal at home and paid for by the host. If astudent chooses to go out for lunch or dinner withtheir friends, it is the students responsibility to pay.
• If required, please provide some additional space inthe kitchen where students can keep snack foodsthat they might purchase for themselves and showthem how to work the kitchen appliances in casethey would like to cook for themselves if hostsaren’t at home.
• Dietary Issues: Students may require a special dietand all care is taken to advise you of this prior totheir arrival. If the special diet (ie vegetarian, halaletc.) is agreed to by the host prior to arrival, hostsare to accommodate these requests and cannotcharge the student additional fees.
• Unlimited Wi-Fi must be available for students toaccess (guidelines about downloading / excessiveuse are provided to the student prior to arrival).
Wintec selects its homestay hosts carefully for their friendly and caring attitude towards international students as well as their good standard of accommodation. All hosts are carefully supervised, receive ongoing support and training and are inspected regularly in order to ensure that they continue to meet Wintec’s high expectations.
In order to make the most of their opportunity to life and study in NZ, students expect to be treated like ‘one of the family’, as without your support and guidance, they are highly likely to struggle to adjust to life in NZ and to overcome homesickness and culture shock.
In return, we expect students to conform to your guidelines & house rules (Wintec requires a copy of any rules provided to students to ensure they meet the hosts contractual obligations and that of relevant Govt legislation).
We have a 24 hour (021 502 418) a day Wintec emergency number which is contactable in case of urgent issues and emergencies. Alternatively, the international student accommodation team at Wintec is also readily available via email or meetings as needed.
Wintec reserves the right to remove a student from a homestay if serious complaints are made, issues of health or safety arise and/or a breach of contract is identified without notice.
Physical requirements
Wintec’s approved homestay hosts are expected to provide the following physical items:
Supportive requirements
Since living with a homestay host is much more than just furniture and bedding, we also expect the following from our homestay hosts:
• A clean, comfortable home with a happy and relaxedatmosphere where students are welcome andtreated like a member of the family.
• Everyone in the house is open to hosting studentsfrom all different countries.
• NZ is very multicultural and not all homestay hostswill speak English as their first language at home.We do however require all family members to have ahigh level of English and it must be the mainlanguage spoken at home. It is not acceptable tospeak your native tongue at home and only speakEnglish when you address your student.
• Have time to help your student, especially intheir first week in NZ, including showing themaround Hamilton (i.e. bank, shopping centre, Asiansupermarket etc.) and accompanying them to/fromWintec on their first day.
• If you are not walking distance to campus, we askthat you travel to Wintec with your student by bus sothat they will know which bus to take. You will alsoneed to do the return journey home as well. Thepurchase of bus cards are the responsibility of thestudent, but they may require assistance whenbuying their first travel card.
• Guidance in personal and school life, including:
- help with new aspects of NZ culture and language
- supporting them to learn and practice good studyhabits and make new friends
- dealing with homesickness and cultural isolation
• Students want to learn and improve their English.Make the time to communicate with them on aregular basis, ask them about their day and teachthem new words.
Additional Requirements
• Medical Assistance: Should your student requirenon-urgent medical attention, students can seekhelp from the doctors/nurses at Wintec free ofcharge. If after hours medical assistance is required,please take your student to Angelsea Medical Centre.For emergencies, please go straight to the hospitaland contact Wintec on the emergency pastoral carenumber immediately.
• Under 18 Students: Students under the age of 18have additional requirements for Homestay hostsincluding enforcing curfews and being subject toextra Wintec visits as well as reports to be providedto Wintec on a regular basis. Further informationabout hosting under 18’s can be found either on ourwebsite or as requested via email.
• Police Vetting: Vetting is required for anyone over 18living in your house or staying overnight on averageof 4 times per month. This is complulsory andstudents will not be placed with hosts until all Policevetting is completed and up to date.
Payments & fees
• Homestay's are not permitted to charge studentsbonds, letting fees or contingency fees.
• Homestay's are not permitted to borrow moneyfrom their students.
• Homestay's are not permitted to act as guarantorsfor students entering into legal agreements.
Keeping in contact with Wintec
• Either the Host or the student may terminate thehomestay arrangement without the need to providea reason, upon giving the other party two weekswritten notice, please also provide notice to Wintec.
• In the case of illness or accident, you will need tonotify Wintec of any student absenteeism.
• Should you become aware of any negative change inthe mood or behaviour of the student, pleasecontact and discuss with a student adviser at theInternational Centre.
• You are required to contact Wintec if your situationchanges ie: additional people move into your home,either temporarily or permanently, you intend tomove residences, there is a separation in the familyunit or you intend to go on holiday or no longer wishto host students.
What you can expect from Wintec:
• 2 compulsory training evenings per year
• At least one official visit per year
• Police Vetting is required every 2-3 years or ashousehold members turn 18
• A 24 hour emergency contact for issues andemergencies
• Student profiles of students who will be placed withyou which will include their arrival times, interestsand preferences.
• Regular check in’s to see how you and your studentsare progressing.
INFORMATION & GUIDELINES FOR STUDENTS UNDER 18
CELL PHONES & ADDRESS CARD
Wintec asks that you get a cell phone and carry this with you at all times. This must be switched on, so that your homestay/your family/or we can contact you at all time. This is for your safety.
You must also save the contact details and address of your homestay family on your phone so that you can contact them at any time, should you need to. Always carry your Homestay’s Address Card with you – if you do not have this, please let us know, and we can provide you with a new card.
ACCOMMODATION
If you are under the age of 18, Wintec does not allow you to live in a flat/room/house/apartment, live on your own or stay in a hostel type arrangement. You must stay in a Wintec approved homestay until you turn 18. If you are not happy in your current homestay family, please come and talk to us. We can see if talking to your family can make things better, or if we need to find you a new family.
If you want to discuss this, please contact Sally on [email protected] or visit the International Centre (B-Block).
ALCOHOL
Drinking alcohol is not allowed until you are over the age of 18. In NZ it is illegal to drink alcohol if you are 16 or 17 years old. It is also illegal for anyone under 18 to be sold alcohol. You will be asked for photo ID.
If you are caught drinking in a bar or in a public place, you may be arrested by the police. Using fake ID cards to get into a club or bar or to buy alcohol is illegal. You will likely lose your student visa if you are caught.
Having friends over 18 buy you alcohol is also illegal, and they can face serious consequences from the police for supplying alcohol to you.
Drinking and Driving in New Zealand results in heavy penalties.
DRUGS
Drugs are illegal in New Zealand and that we have zero tolerance towards the use and/or sale of drugs. If you are caught with drugs (even if they are not yours), it will be referred to the police and this will likely result in your Student Visa being revoked and having to return home.
SMOKING
In New Zealand, it is illegal to sell cigarettes to anyone under the age of 18. You will not be able to buy smokes until you are 18+. They will ask you for photo ID.
All of the Wintec campuses are smoke free – you are not allowed to smoke anywhere on campus. You are also not allowed to smoke at your homestay family’s house (unless you have permission from them).
SAFETY
If you are returning home after dark, especially if you are taking the bus, you must keep an eye on your personal belongings, particularly purses and wallets. Also, be very careful when withdrawing money, e.g. from a bank. It is best that if you are out after dark, that you contact your homestay family so that they can come and get you – this will be the safest option.
HOLIDAYS & SLEEP-OVERS
If you want to go away and spend time away from your homestay (for example if you go on holiday, spend the night at a friend’s house, return home etc.) then you must seek prior permission:
• You must tell your homestay family of your plans
• You must inform the International Centre of yourplans and provide us with the following:
• Your contact details
• Where you are going (e.g. Motel details)
• Who you are going with
• How you are getting there/home
• How long you will be away
• Contact details of someone else in your group
• We must receive written permission from yourparents (i.e. an email) to confirm that they give youpermission to stay away overnight. This must bereceived before you travel/leave. If your parentsdo not speak English, then they can email us inChinese, Russian etc.
If you are under the age of 18, you are considered a minor in New Zealand, and your homestay families have been specifically selected to look after you.
As a minor in New Zealand, there are certain rules that Wintec requires you to abide by in order for us to be able to ensure your safety and wellbeing. These are:
PARTIES
If you want to go to a party, event or function, you must have prior permission from your homestay family. The need to know:
• Where the party is
• Who will be at the party (e.g. other students)
• Will it be supervised?
• Contact details
You must be home no later than 11pm unless we have permission from your parents to say that you are allowed to sleep-over etc. This must be received before the party.
At the party, you are not allowed to drink any alcohol and/or take any drugs. If you do, you can be in serious trouble and receive an official warning from Wintec.
DRIVING
You may not own or drive a car unless you have a current New Zealand Drivers Licence. Do not drive your friend’s car. Do not ask to borrow your homestay’s car.
If you do drive a car, we strongly recommend that you take out fully comprehensive insurance.
CURFEW
There is a standard curfew set by the International Centre for all students under 18:
• Sunday – Thursday you must be home by 9pm
• Friday & Saturday you must be home 11pm
If you want to come home after these times, you need prior permission from your homestay family who must be able to contact you (i.e. have your cell phone turned on loud & with you at all time), and must know where you are and when you do expect to be home. If you do get lost, into trouble etc. and need ride home, please contact your homestay family to help you.
You are not allowed to skip classes because you are too tired to attend because you came home late.
BIKING IN NZ
If you decide to bike to/from Wintec, then you must wear a helmet – it is illegal to ride a bike without a helmet in NZ. Your homestay family can show you where to purchase these.
ATTENDANCE
You must attend all your classes. If you are sick, your homestay family can contact the International Centre, we will advise your tutors. If you are sick for more than 2 days, you must see a doctor/nurse at the Wintec health centre (located in A-Block). This is free if you take in your insurance documents.
If your attendance is low, your school of study will contact us and you will need to come and see us to explain. If there is a reason of why you are not attending, we will try and help you (e.g. extra support in class, meet other students your own age, personal issues etc.). We will need to inform your parents about your low attendance and what we are doing to help you.
If your attendance does not improve, you will be issues a written warning from Wintec and may have your enrolment cancelled. If this happens, your student visa will be invalid, and you will need to return home immediately.
STUDENTS WHO REPEATEDLY FAIL TO COMPLY WITH WINTEC RULES, HAVE LOW ATTENDANCE IN CLASS AND/OR BREAK THE RULES SET BY THEIR HOMESTAY FAMILIES MAY RECEIVE AN OFFICIAL WARNING, BE REMOVED FROM THEIR HOMESTAY AND CAN HAVE THEIR ENROLMENT WITH WINTEC CANCELLED.
HOMESTAY APPLICATION DOCUMENTATION CHECKLIST
Application completed with no spaces empty (N/A where appropriate)
Rules read and understood
Application Signed by all Hosts
Photo of family included
Photos of the house both inside and out to be provided with application
Police vetting forms completed for everyone living or staying in the house over the age of 18
Two forms of ID provided for each Police Vetting to be verified or physically sighted by Wintec Staff
Completed Profile form filled and returned to Wintec
Please check over your application documentation and ensure all information below is included. Submit this completed checklist with your application.
HOMESTAY APPLICATION FORM
Application Form Instructions:
1. Once completed, please scan and email all required documentation direct [email protected]
2. Please print clearly and complete all sections in this application form. Use N/A whereappropriate.
3. Please give honest and complete answers and be sure to sign/date the form
Family Surname :
Address :
Home Phone:
Email Address : How long have you lived at this address :
Who will be the main contact for hosting:
What is the best/preferred way to contact you:
HOST PARENT 1
Name:
Date of Birth: MALE / FEMALE
Work Place:
Occupation:
Days/Hours of Work:
Professional Memberships:
Work Number: Mobile Number:
HOST PARENT 2
Name:
Date of Birth: MALE / FEMALE
Work Place:
Occupation:
Days/Hours of Work:
Professional Memberships:
Work Number: Mobile Number:
1
FAMILY DETAILS
CHILDREN
Yes / No
Children’s Names Date of Birth School or Occupation Male / Female Living at Home
OTHER PEOPLE IN YOUR HOME (i.e. boarders, additional family members etc.)
Other People living in your house Date of Birth School or Occupation Male / Female Relationship
Are there any other people not listed here, that regularly spend time at your house and/or stay the night? (ie; once a week) This could include additional family members, friends, partners or boy/girlfriends)? YES / NO
Other People living in your house Date of Birth School or Occupation Male / Female Relationship
GENERAL INFORMATION
NATIONALITY / LANGUAGES
What is your Nationality?
Other than English, what other languages are spoken in the house?
POLICE RECORD
Does anyone living in the household (or staying regularly) have any criminal convictions, or had any complaints investigated by police? 1
YES / NO
If yes, please provide brief details here including dates and circumstances:
ILLNESS / DISABILITY
Does any member of the family live with a long-term illness or disability? YES / NO
If yes, please provide details here:
1 Please note that Police Vetting for Homestay Hosts are exempt from the clean slate scheme so the following information may be disclosed accordingly: Conviction History, Driving demerit point or suspension of licence, Family violence information, any interaction with Police(including as a victim) and any information about violent or sexual behaviour that did not result in a conviction.
2
Animal Type Size Short Hair/Long Hair Inside/Outside
HOUSEHOLD INFORMATION
Total number of bathrooms in the house
Number of bedrooms available for international students
These questions are about your house:
Total number of bedrooms in the house
Total number of toilets in the house
Do you have a home phone line? YES / NO
Do you have unlimited Wifi available?2 YES / NO
If no, provide details, e.g. dial-up, broadband, wifi + monthly limit:
Monthly internet limit for the household:
PETS
Do you have any pets? YES / NO
If so, please provide details here:
E.g. Dog Golden Labrador Medium Short Hair Inside
TRANSPORTATION TO/FROM WINTEC
How would your student(s) get to Wintec each day (i.e. take the bus, walk, get dropped off…):
Do you have a bus stop close to you house for students to get to Wintec City Campus?
How far do students have to walk to this bus stop?
What bus routes are available to students?
Would you be available to take your student to Wintec on their first day? YES / NO
Notes:
2 Please note: Most international students will experience some degree of homesickness and they will be keeping in touch with family/friends via email, Skype, news etc. Wintec strongly recommends Hosts to have unlimited Wifi plans.
3
HOSTING A STUDENT
Why do you want to host international students through Wintec?
Have you ever hosted an international student before? YES / NO
If so, please provide some details here (i.e. who did you host through, how old was the student, how long did they stay with you etc.):
Are you currently registered with any other organisations? YES / NO
If so, who?
STUDENT PREFERENCES
How many students are you intending to host at any one time?
The following questions are for matching purposes; please answer each question about your preference (but we will also review these re-
sponses again during our homestay visit with you):
MALE FEMALE
YES NO
YES NO
YES NO
YES NO
STUDENT
Gender Preference
Preferred Nationalities?
Is there any country where you do not want to host student from?
If yes, please list here:
Would you be willing to host an U18 student?3
Would you be willing to host a Scholar or more mature students
SMOKING
Does anyone at home smoke?
Are you willing to host a student that smoke? YES NO
If yes, are there any restrictions to this (e.g. can only smoke outside)?
3 Please ensure you know the special rules/regulations surrounding hosting a student that is under 18 before answering this question.
4
DIET
Is your family Vegetarian? YES NO
Would you be willing to host a vegetarian student? YES NO
Is your family Vegan? YES NO
Would you be willing to host a vegan student? YES NO
Does your family follow a Halal diet? YES NO
Would you be willing to host a Halal student? YES NO
Does anyone in your family have any food allergies? YES NO
If yes, please provide details here (e.g. Bob is allergic to peanuts):
Are you willing to host to student with food allergies? YES NO
Comments:
4 Please note that this is only used for matching purposes and is optional
YOUR FAMILY AND FREE TIME
How would you describe the personality of your family (i.e. quiet, sporty, outgoing, adventurous, etc.)
BELIEFS, PERSONALITY AND INTERESTS
Please specify your religion and denomination4:
How often do you attend religious services? NEVER OCCASIONALLY WEEKLY MORE THAN ONCE A WEEK
FAMILY ACTIVITIES
What sporting activities do you and your family part-take in?
What hobbies do you enjoy?
5
REFEREES
Please provide two referees (non-relatives) who could provide information on your suitability to care for students:
REFEREE 1
Mobile
Name
Day-time Telephone
Relationship to you
Work No. Email
REFEREE 2
Mobile
Name
Day-time Telephone
Relationship to you
Work No. Email
PRIVACY AND PHOTOS
I/We give permission to Wintec to contact our referees and discuss our suitability to hosting and caring for international students.
I/We understand that if this application is successful, photographs provided to or taken by Wintec Accommodation staff as part of the
Homestay interview and assessment process may be stored on Wintec's Homestay database for a period of up to three years.
I/We agree/do not agree (circle one) to our photos being used as part of the packs Wintec provides to students allocated to stay at your
home. If at any time during the three year period I/We wish to withdraw my/our consent, I/we can do so in writing
DECLARATION
This form is to provide information solely for the purpose of organising students into accommodation and it will be viewed only by the staff of
the International Centre at the Waikato Institute of Technology and will not be used for any other purposes.
I/We have read and understood the Homestay Host guidelines and expectations provided to us with this application form and
acknowledge that any breach of these could result in my/our immediate removal from Wintec's Homestay network.
I/We declare that the information provided in this form is true correct.
Full name of Host Full name of Host
Signature of Host Parent Signature of Host Parent
Date Date
6
Signed in Electronic Form Signed in Electronic Form
NZPVS-CS - 12/16
New Zealand Police Vetting Service – Guide to completing the Request and Consent Form - 3
Evidence of Identity:The purpose of this section is to confirm the identity of the applicant to ensure the correct person is being vetted to a standard accepted by New Zealand Police for vetting purposes. This is based on identity confirmation requirements set out in the Vulnerable Children Act Regulations 2015.
In order to confirm the identity of the applicant, two forms of ID must be sighted, one primary and one secondary, one of which must be photographic.
Primary IDs include: Passport (NZ or Overseas)
NZ Firearms Licence
NZ Full Birth Certificate (issued on or after 19981)
NZ Citizenship Certificate
NZ Refugee Travel Document
NZ Emergency Travel Document
NZ Certificate of Identity
Secondary IDs include: NZ Driver Licence
18+ card
NZ Full Birth Certificate (issued before 1998)
Community Services card
SuperGold Card
NZ Employee Photo Identification Card
NZ Student Photo Identification Card
Inland Revenue number
NZ issued utility bill (issued not more than six
months earlier)
NZ Teachers Registration certificate
NZ Electoral Roll Record
International Driving Permit
Steps to Freedom Form
Current identity documents are preferred, but documents that have expired within the past five
years may be accepted.
If an applicant is unable to meet the requirements for evidence of identity, please contact the Police
Vetting Service at [email protected].
Evidence of a name change
If the two identity documents have different names (e.g. a birth certificate contains the applicant’s
maiden name and a driver licence contains their married name) evidence of a name change must
be sighted such as a marriage certificate or statutory declaration.
Assertion of a RealMe verified identity
Approved Agencies who have the technical capability to accept an online assertion of an applicant’s RealMe verified identity may use this instead of sighting two forms of identity documents.
For information about accepting an assertion of a RealMe identity, please see:
https://www.realme.govt.nz/realme-business/how-realme-works-businesses/.
1 The Vulnerable Children Regulations 2015 states that a NZ Birth Certificate may only be used as a Primary identity document if issued on or after the 1st of January 1998 and carrying a unique identification number.
Vetting Service Request & Consent Form
NZPVS-CS - 06/18
Section 1: Approved Agency to complete (For more information please see the Guide to Completing the Consent Form - http://www.police.govt.nz/advice/businesses-and-organisations/vetting/forms-and-guides)
Name of Approved Agency submitting vetting request:
Name of Applicant to be vetted:
Description of Applicant’s role:
Applicant’s purpose Employee Contractor/Consultant Volunteer Prosecution
Vocational Training Licence/Registration Visa/Work Permit Other
What group(s) will the applicant have contact with in their role for your agency? Children/Youth Elderly Other Vulnerable Adults Other
What is the applicant’s primary role for your agency? Caregiving (Children) Caregiving (Vulnerable adults) Healthcare Education Other
Will the role take place in the applicant’s home? Yes No
Will the applicant be a volunteer or paid for their role?
Paid Volunteer
Is this request mandatory under the Vulnerable Children Act 2014 (VCA)? Yes: Core childrens worker Yes: Non-core childrens worker
No (mandatory under other legislation/optional/standard Police Vet)
If this is a mandatory Vulnerable Children Act request, please specify the check reason below: New Children’s Worker Existing Children’s Worker VCA Renewal
Evidence of Identity (to be completed by agency representative/delegate or identity referee - see guide for details)
A primary ID has been sighted (Mandatory) A secondary ID has been sighted (Mandatory)
One form of ID is photographic (Mandatory) Evidence of name change has been sighted (if applicable)
OR: If your organisation is able to accept a verified RealMe identity then:
An assertion of a RealMe identity has been received (see guide for further information).
In making this request, I confirm that: I have complied and will comply with the Approved Agency Agreement I am satisfied with the correctness of the applicant’s identity I have obtained the Applicant’s authorisation to submit this vetting request as set out in section 3 of this form Approved Agency Authorised Representative:
Name: Date:
Signature: Electronic Signature
Page 1 of 3
Vetting Service Request & Consent Form
NZPVS-CS - 06/18
Name of Approved Agency submitting vetting request:
Section 2: Applicant to complete and return to Approved Agency *Denotes a mandatory field Personal Information
Details (note: the name you are most commonly known by is your primary name)
*Family name (Primary):
Given name(s):
*Gender: (M) (F) (Other)
*Date of birth: (dd/mm/yyyy)
Place of birth: (Town/City/State)
*Country of birth
NZ Driver Licence number:
Previous names: If applicable, please include other alias or alternate names; married name if not your primary name; previous/maiden/name changed by deed poll or statutory declaration. Family name First name Middle names
Permanent Residential Address
*Number/Street:
Suburb: Post Code:
*City/Town/ Rural District:
Page 2 of 3
Vetting Service Request & Consent Form
NZPVS-CS - 06/18
Section 3: Applicant to complete and return to Approved Agency Consent to release information 1. The New Zealand Police may release any information they hold if relevant to the purpose of this vetting request.
This includes:
• Conviction histories and infringement/demerit reports • Active charges and warrants to arrest • Charges that did not result in a conviction including those that were acquitted, discharged without conviction,
diverted or withdrawn
• Any interaction I have had with New Zealand Police considered relevant to the role being vetted, including investigations that did not result in prosecution
• Information regarding family violence where I was the victim, offender or witness to an incident or offence, primarily in cases where the role being vetted takes place in a home environment where exposure to physical or verbal violence could place vulnerable persons at emotional or physical risk.
• Information subject to name suppression where that information is necessary to the purpose of the vet
2. If I am eligible under the Criminal Records (Clean Slate) Act 2004, my conviction history will not be released unless: a. Section 19(3) of the Clean Slate Act applies to this request (exceptions to the clean slate regime) b. Section 31(3) of the Vulnerable Children Act 2014 applies to this request (safety checks of core children’s
workers). c. The vetting request is made by an individual for the purpose of an overseas Visa/Work Permit as a Privacy Act
request authorising the vetting result to be provided directly to the relevant embassy, high commission or consulate.
Please see the guide for more information regarding the Clean Slate legislation.
3. The Police Vetting Service may disclose newly-obtained relevant information to the Approved Agency after the completion of the Police Vet in the following circumstances:
• The disclosure of the newly-obtained information is considered to be justified under the Privacy Act 1993 (if it had existed or been available at the time of the Police vet, it would have been disclosed); and
• The Police Vetting Service has taken steps to confirm that the purpose of the Police vet still exists – e.g. that I got the role which required a Police vet and am still employed or engaged in it.
The Vetting Service will endeavour to notify you prior to the disclosure.
4. Information provided in this consent form may be used to update New Zealand Police records.
5. I am entitled to a copy of the vetting result released to the Approved Agency (to be provided by the agency) and can seek a correction by contacting the Vetting Service.
6. The Approved Agency will securely dispose of this consent form, copies of identification documents and the vetting result within 12 months of receiving the result unless a longer retention period is required by legislation.
7. I may withdraw this consent, prior to Police’s disclosure of the vetting result, by notifying the Approved Agency.
For further information, please see the Guide to Completing the Consent Form.
Applicant’s Authorisation: I confirm that the information I have provided in this form relates to me and is correct.
I have read and understood the information above.
I authorise New Zealand Police to disclose any personal information it considers relevant to my application (as described above) to the Approved Agency making this request for the purpose of assessing my suitability at any time.
Name: Date:
Signature:
Electronic Signature
Page 3 of 3
Vetting Service Request & Consent Form
NZPVS-CS – 06/18
Section 4: Applicant to complete for Australian check (if required) Additional Personal Information (for Australian National Police History Check) Last Permanent Australian Residential Address
*Number/Street:
*Suburb: *Post Code: *City/Town/ Rural District: *State or Territory:
*Period of Residence Start date (dd/mm/yyyy) *Period of Residence
End date (dd/mm/yyyy)
Australian Driver's Licence No: (if applicable) Issued by:
Australian Firearms Licence No: (if applicable) Issued by:
General Information for an Australian National Police History Check General Information Australian Criminal Intelligence Commission (ACIC) is collecting your personal information in this form in order to conduct a National Police History Check (NPHC) on you. Approved Agencies in New Zealand, named in section one, use the personal information collected on this form and the resulting NPHC as part of the assessment process to determine suitability for the position/entitlement/benefit which you are applying for.
Unless statutory obligations require otherwise, the information provided on this form will not be used without your prior consent for any purpose other than in relation to the assessment of your suitability or to maintain the records of ACIC, Australian Police Agencies1, or NZ Police.
You will be required to complete another consent form for any future NPHC checks.
National Police History Check (NPHC) A NPHC is an integral part of the assessment of your suitability. Information on this form will be used by ACIC, and Australian Police Agencies for checking action; it will also be used to update records held about you by ACIC, Australian Police Agencies and NZ Police. Information released may include outstanding charges, warrant information and criminal convictions/findings/pleas of guilt recorded against you that may be disclosed according to the laws of the relevant jurisdiction and, in the absence of any laws governing the release of that information, according to the relevant jurisdiction information release policy.
Limitations on accuracy and use of Police History Information While every care has been taken by ACIC to conduct a search of information held by Australian Police Agencies that relate to the applicant, the accuracy and quality of this NPHC depends on accurate identification of the Applicant (including aliases) according to the information provided in the Request and Consent Form and the comprehensiveness of police records. If the applicant does not complete the information requirements in this form the success and validity of the NPHC will be compromised.
If for any reason you do not agree with the results of your NPHC, please notify the Approved Agency that you submitted the check through in the first instance, so that the NPHC dispute process can be initiated. The release of information by Australian Police Agencies is subject to relevant Spent Convictions, non-disclosure legislation or information release policies. Spent Conviction Schemes The aim of Spent Convictions legislation2 is to prevent discrimination on the basis of certain previous convictions. Spent Convictions legislation limits the use and disclosure of older, less serious convictions and findings of guilt. Each Australian Police Agency will apply the relevant Spent Convictions legislation/information release policy prior to disclosure.
1 Australian Federal Police, ACT Policing, The New South Wales Police Force, Queensland Police Service, South Australia Police, Victoria Police, Western Australia Police, Northern Territory Police Force, Tasmania Police Service
2 Applicable Spent Conviction legislation, as amended from time to time
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Vetting Service Request & Consent Form
NZPVS-CS – 06/18
General Information for an Australian National Police History Check, (continued) The following links may be helpful in sourcing information on Spent Convictions in the Australian States & Territories but may not be relied upon. If further information or clarification is required please contact the individual Australian Police Agencies directly for further information about their release policies and any legislation that affects them.
Commonwealth www.comlaw.gov.au New South Wales www.legislation.nsw.gov.au Queensland www.legislation.qld.gov.au
South Australia www.legislation.sa.gov.au Victoria Police www.police.vic.gov.au Tasmania www.thelaw.tas.gov.au
Western Australia www.slp.wa.gov.au Northern Territory -www.nt.gov.au/dcm/legislation/current.html Australian Capital Territory www.legislation.act.gov.au
Provision of incomplete, false or misleading information An Approved Agency or Applicant must take reasonable steps to ensure that the personal information collected, or disclosed is accurate, complete and up to date.
You are asked to certify that the personal information you have provided on this form is correct. If it is subsequently discovered, for example as a result of a check of police records, that you have provided incomplete, false or misleading information, you may be assessed as unsuitable.
It is a serious offence to provide false or misleading information in Australia.
Consent to disclosure (for Australian National Police History Check) 1. I have read the General Information in section 3 of this form and understand that information will be disclosed in
accordance with applicable legislation and information release policies (including spent convictions legislation, however described) in the Commonwealth, States and Territories;
2. I understand that the position/entitlement for which I am being considered may be in a category for which exclusions from Spent Convictions legislation may apply;
3. I have fully completed this form, and the personal information I have provided in it relates to me, contains my full name and all names previously used by me, and is correct;
4. I acknowledge that the provision of false or misleading information is a serious offence;
5. I acknowledge that the Approved Agency named in Section 1 of this form is collecting information in this Form to provide to New Zealand Police to provide to ACIC (an Agency of the Commonwealth of Australia) and the Australian Police Agencies;
6. I consent to: a. ACIC using and disclosing personal information about me in this form to the Australian Police Agencies;
b. the Australian Police Agencies disclosing to ACIC, from their records, Police History information that can be disclosed in accordance with the laws of the Commonwealth, States and Territories and in accordance with the relevant jurisdiction’s information release policies;
c. ACIC disclosing the information disclosed by the Australian Police Agencies to New Zealand Police, and
d. New Zealand Police disclosing any criminal history information about me to the Approved Agency named in Section 1 of this form to assess my suitability in relation to my application;
7. I acknowledge that any information provided by me in this form relates specifically to the purpose identified in Section 1 of this form;
8. I acknowledge that any information provided by the Australian Police Agencies or ACIC relates specifically to the purpose identified in Section 1 above;
9. I acknowledge that personal information that I provide in this form may be disclosed to the Approved Agency named in Section 1 of this form (including contractors or related bodies corporate) located in New Zealand or overseas; and
10. I acknowledge that it is usual practice for an Applicant's personal information in this form to be disclosed to New Zealand Police and Australian Police Agencies for them to use for their respective law enforcement purposes including the investigation of any outstanding criminal offences.
Note: The information provided in this form will be used only for the purpose stated above unless statutory obligations require otherwise. Applicant’s Authorisation:
I have read and understood the information above and consent accordingly. Signed in electronic form
or, Signature: ____________________________ Date:
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