Details of contact person (if different from 2 above); Address: ________________________________________________________________ Town __________________________ Postcode: __________________________ Phone number: ______________________ Fax Number: _____________________ E-mail address: ________________________________ SECTION TWO - ORGANISATION DETAILS (Please note: If you have received a grant since 1st April 2006: DO NOT complete questions 1 and 2 Only complete items 3 and 4 if circumstances have changed since your last application Complete all other questions What does your organisation do (no more than 100 words)? In what year was your organisation started? What type of organisation are you?(√) Unincorporated club or association Company limited by guarantee Company limited by shares Recognised charity Trust Local Authority Other: Please specify ______________________ Recognised Charity Number (if applicable) ________________________ VAT Registration Number (if applicable) _______________________ Please list the names and positions of the 3 main office-holders in your organisation:
Learning outcomes from safeguarding training. Name of designated Safeguarding Officer (Please provide name of body in comments) Does your organisation regularly re-evaluate and update your safeguarding training and education? Copy of letters/memos/certificate outlining Safeguarding training provided to staff. Does your organisation have written procedures for reporting child protection concerns, disclosures and allegations? Written procedures for reporting concerns to Designated Officer and statutory services Pro formas/written guidance. Are the procedures for reporting concerns communicated to staff and volunteers? Confirmation from staff (especially recently recruited) that they have received safeguarding training and written reporting procedures Does your organisation have an open complaints process that includes guidelines on a disciplinary process? Copy of complaints, disciplinary and appeals process. Evidence of how this is communicated to stakeholders Does your organisation have written procedures for Designated Officers? Written documents stating the name and up to date contact details of Designated Officers.(Please name Designated Safeguarding Officer(s)in comments) Are the contact details of Designated Officers communicated to staff/volunteers? Written evidence to support that staff, members and volunteers are aware of who to contact and how. Confirmation from staff/volunteers Do you have a written Code of Behaviour? Written Code of Behaviour Evidence this is communicated to all stakeholders Do you have a written Safeguarding policy and procedures, endorsed and approved by Management Board? Written Policy Statement and associated procedures Please advise when last reviewed and updated. Do you communicate your Safeguarding policy statement to staff/volunteers/children/ young people/ vulnerable adults and parents? Confirmation from staff/ volunteers/ children/ vulnerable adults and parents that they received a copy or know where to access the policy SAFEGUARDING CHECKLIST COMPLETED BY:
The main group to benefit, will be: (by main group we mean more than 60%) Please () one box only People with dependants People without dependants People with dependants and people without dependants (where neither community is over 60%) We are unable to specify which group will mainly benefit Religious Belief The main group to benefit, will be: (by main group we mean more than 60%) Please () one box only Protestant Catholic Both Protestant and Catholic communities (where neither community is over 60%) Buddhist Hindu Islam / Muslim Jewish Sikh Other Religious Belief We are unable to specify which group will mainly benefit Political Opinion The main group to benefit, will be: (by main group we mean more than 60%) Please () one box only Nationalist generally Unionist generally Other We are unable to specify which group will mainly benefit Racial Group The main group to benefit, will be: (by main group we mean more than 60%) Please () one box only Black African Black Caribbean Other Black Background Indian Pakistani Bangladeshi Other Asian Background Chinese Mixed ethnic group