Please complete application below and a member of Neighbourhood Watch NT will contact you soon to finalise your application.
Please list all previous residential addresses for the last 5 years.
How did you hear about Neighbourhood Watch NT?
Which of the following activities would you be interested in assisting with?
Can you speak any other languages?
I certify that I am the applicant named in this form and all the details provided by me are true and correct. I have not omitted names of aliases that I have or may have used previously. I have read and understood the contents of this form.
I consent to the release of my personal details to Safe NT for the purpose of a working with children screening. I understand that Safe NT will obtain information about my criminal history and any additional information relating to that record from sources which may include courts, police, prosecution agencies or previous employers. I understand that the information obtained includes, but is not limited to, details of convictions and pending charges or information relating to offences committed or allegedly committed by me, regardless of when and where the offence or alleged offence occurred.
I understand that Safe NT will make use of that information and any subsequent information about my criminal history which may be obtained to enable a full and informed assessment of risk.
I authorise Safe NT to release information to NHWNT, if at any time my clearance notice is revoked or subject to imposed conditions.