THE JOBSEEKER
|
Last name:
|
|
First name:
|
|
Middle name:
|
|
Date of birth:
|
|
Aliases including nicknames:
|
|
Gender:
|
|
Current address:
|
|
Postcode:
|
|
Telephone number:
|
(h)
|
|
(m)
|
|
Disability / Diversity considerations:
|
|
2. NOTIFYING AGENCY
|
Notifying agency:
|
Probation Service / Police
|
Name:
|
|
Grade:
|
|
Office:
|
|
Telephone number(s):
|
(w)
|
|
(m)
|
|
Email address:
|
|
Date Jobseeker informed of Jobcentre Plus notification:
(In exceptional circumstances where Jobseeker not informed, give date of discussion with Jobcentre Plus Designated Officer / SPOC)
|
|
Does the offender present a risk of serious harm to Jobcentre Plus staff or other employment and training providers?
|
YES / NO
|
If YES:
Describe the nature of the risk of serious harm and contact the Jobcentre Plus Designated Officer / SPOC to discuss.
|
|
3. MAPPA POINT OF CONTACT
|
Name:
|
|
Office:
|
|
Telephone number(s):
|
(w)
|
|
(m)
|
|
Email address:
|
|
4. INITIAL RESTRICTIONS / CHANGE OF RESTRICTIONS
which will affect the employment / training of the Jobseeker
|
Initial Restrictions / Change of Restrictions [delete as appropriate]
|
Date restriction ends
|
|
|
|
|
|
|
|
|
Date notification emailed to JCP designated Officer/SPOC:
|
|
Date by which JCP Designated Officer / SPOC should contact lead agency to discuss (within five working days, if notification restriction/change of restrictions):
|
|
5. NO RESTRICTIONS APPLY
|
complete only when there is serious concern regarding employment and the need to protect the public from serious harm
|
Date discussed with Jobcentre Plus Designated Officer / SPOC:
|
|
Information shared:
|
|
Yüklə 80.5 Kb.