WESTERN AUSTRALIA POLICE

APPLICATION FOR A LICENCE

Security & Related Activities (Control) Act 1996
Instructions to applicants follow all of these steps to complete your application
You must carefully complete all sections and attach all required documents. INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED. If you have any queries regarding the completion of this application, contact Police Licensing Services on 1300 171 011

Section 1
Personal Details Record your full complete name, residential address, postal address, date and place of birth, all current telephone numbers and email address. Complete details of your physical description. Enter the year and state you arrived in Australia. Enter your motor driver licence and passport particulars.

Section 7
Signing the Firearms/Baton Declaration Do not sign this without a Member of the Western Australia Police present to witness your signature.

Penalties Apply for Omissions, False or Misleading Information.

Application Checklist
- All application details completed including Code of Conduct. - Correct licences types nominated. - Full particulars of personal history, including criminal record or Police employment completed. - All relevant documentation provided. - Full application fees payable. Crowd Controller / Security Officer / Investigator / Security Bodyguard Applicants for these licence types must have completed an approved training course prior to lodging the application. Security Installer Class 1: Install, maintain or repair safes, vaults and locks of a kind prescribed in Regulation 6. Must be a trade qualified Locksmith to obtain this licence. Class 2: Install, maintain or repair security alarms, CCTV for security purposes, equipment and devices prescribed in Regulation 8. A pre-licence test based on AS2201.1 for alarms and AS4806 for CCTV must be completed with a minimum of 80% to pass the test. Class 3: Install, maintain or repair security doors as prescribed in Regulation 7. A pre-licence test based on AS5040 must be completed with a minimum of 80% to pass the test. Class 4: Install locks of a kind prescribed in Regulation 6. No pre-licence test or trade certificate is required. Security Consultant Class 1: Consult in safes, vaults and locks of a kind prescribed in Regulation 6. No pre-licence test or trade certificate is required. Class 2: Consult in security alarms, CCTV for security purposes, equipment and devices prescribed in Regulation 8. A pre-licence test based on AS2201.1 for alarms and AS4806 for CCTV must be completed with a minimum of 80% to pass the test. Class 3: Consult in security doors as prescribed in Regulation 7. A pre-licence test based on AS5040 must be completed with a minimum of 80% to pass the test. Class 4: Consult in matters relating to watching, guarding and protecting of property. Must have completed an approved training course prior to lodging an application.

Section 2
Licence Category Select which category of licence you wish to obtain and tick the corresponding box. Select term of licence required.

Section 3
Personal History 3.1 & 3.2 - Conviction History Record details of any conviction and penalty imposed by a court, whether within Australia or overseas. This includes criminal, traffic or childrens court convictions (include Spent convictions or where a conviction was not recorded). 3.3 - Previous Names Provide details of any other names that you have been known by. 3.4 - Previous Police Service Provide details of any employment in a Police Force or Police Service, including in a civilian capacity. 3.5 - Employment History Provide details of your employment history for the past five (5) years.

Section 4
Signing the Declaration Do not sign this without a member of the Western Australia Police present to witness your signature.

Section 5
Endorsement Select the endorsement(s) that you wish to have included on your Security Officer Licence and tick the corresponding box. Firearm endorsements require an accompanying letter from a licensed Security Agent who holds a Corporate Firearms licence. Baton endorsements require proof that you have successfully completed an approved Baton course within the past six months. Baton endorsements also require an accompanying letter from a licensed Security Agent stating that it is required for security duties.

Section 6
Employer Corporate Firearms Licence Details Firearm endorsements require an accompanying letter from a licensed Security Agent who holds a Corporate Firearms licence.

Form SL

WESTERN AUSTRALIA POLICE APPLICATION FOR A LICENCE

Security & Related Activities (Control) Act 1996

DOCUMENTS TO SUPPORT APPLICATION

If you apply for a licence under the Security and Related Activities (Control) Act, you must support your application with the correct documentation. This will explain what documents are required and where such documentation may be obtained. If you have any queries regarding applying for a licence, contact Police Licensing Services on 1300 171 011. In all cases, the documents presented must be: Original documents and have a copy attached. In English or have an official translation attached.

DOCUMENTS REQUIRED FOR LICENCE APPLICATION

PROOF OF AGE AND IDENTITY Applicants must provide evidence of age and identity to accompany this application. It is to consist of the original and a certified copy of either: Two (2) documents referred to in the Category 1 list; or One (1) document referred to in the Category 1 list and two (2) documents referred to in the Category 2 List. CATEGORY 1: Current motor drivers licence bearing the name, date of birth and photograph of the applicant that has been issued under a law of the Commonwealth or a State or Territory. Current passport or a passport that has not been expired for more than two (2) years, bearing the name, date of birth and photograph of the applicant. Proof of age card bearing the name, date of birth and photograph of the applicant. Identification card (other than a proof of age card) bearing the name, date of birth and photograph of the applicant that has been issued by an agency of the Commonwealth or a State or Territory to provide evidence of the persons identity. Birth certificate bearing the name and date of birth of the applicant issued under a law of the Commonwealth or a State or Territory. Diplomatic document bearing the name, date of birth and photograph of the applicant that has been issued by a government agency to provide evidence of the persons legal entitlement to enter Australia.

CATEGORY 2: Current licence (other than a motor drivers licence) or current permit bearing the name and date of birth of the applicant that has been issued under a law of the Commonwealth or a State or Territory. Current identity card or licence bearing the name and date of birth of the applicant that has been issued by a government agency outside Australia. Identification card bearing the name of the applicant that has been issued by an agency of the Commonwealth or a State or Territory to provide evidence of the persons entitlement to a health benefit or pensioner concession. Identification card bearing the name of the applicant that has been issued within the last (five) 5 years by an Australian educational institution.

NOTE: If insufficient proof of age and identity is received, your application will not be accepted. PERSONAL REFERENCES / TESTIMONIALS Two (2) personal references are required. These references need to be about your character, not your work history. (Please refer to Suitability Reference sheet on pages 10 & 11). They are to be completed in the authors own hand-writing: The referee needs to have known the applicant for a period of five (5) years or longer prior to making this application. Contain the full name of the referee. Contain the address and contact details of the referee. Nature of relationship (referee to applicant). Where and when the relationship was. How long the referee has known the applicant. Must refer to the applicants honesty, integrity, character, etc

You need to have known the person supplying the reference for a five year period or longer prior to the application date
NOTE: A referee cannot be related to you by birth or marriage (includes partners/defactos) or be a serving member of the WA Police.

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PASSPORT PHOTOGRAPHS A set of four (4) passport size photographs is to be included with each application. These photographs are to: Display the head and shoulders (full face), and be on a white or very light background. No eye altering contact lenses or shaded glasses are to be worn.

CRIMINAL RECORD If you have not been a resident of Australia for the last 5 years, or if you are an Australian resident and you have spent more than 12 consecutive months outside of Australia in the past 5 years prior to lodging your application, you must supply relevant documents from the countries you have resided in to prove you have no criminal record. If you are unsure of what this means, contact Police Licensing Services for further information. Police Clearance Certificates (PCCs) issued at a village or town or issued by a District Superintendent are unacceptable as they do not cover the country on a national basis. PROOF OF COURSE COMPLETION / QUALIFICATIONS If you are applying for a non-agent licence, you may be required to have completed a particular training course with an authorized Registered Training Organisation before lodging your application. Security Officer: Certificate II in Security Operations. Security Officer Guarding with a Dog: Certificate II in Security Operations with specific elective units. Crowd Controller: Certificate II in Security Operations with specific elective units. Armed Security Officer: Certificate III in Security Operations. Security Bodyguard: Certificate III in Security Operations. Investigator: Certificate III in Investigative Services. Batons endorsement: Control Person Using Baton Certificate. Consultant (Class 4): Certificate IV in Security Risk Management.

Details of approved courses can be obtained on Police Licensing Services website www.police.wa.gov.au. FIREARMS ENDORSEMENTS MEDICAL CERTIFICATE Applicants for firearms endorsements are required to provide a medical certificate to demonstrate that they are fit to carry a firearm. This medical certificate is to state: That in the opinion of the Medical Practitioner, the person is physically and psychologically fit for use and carriage of firearms, That the examination included the persons hearing and eyesight; and A statement from the Medical Practitioner as to the period the Medical Practitioner has known the person.

Additionally, a new medical certificate is to be supplied on an annual basis to maintain the firearms endorsement. All medical certificates are to be provided to Police Licensing Services within one month of being prepared by the medical practitioner. If you have any questions relating to the documents required to support a licence or endorsement application, you should obtain a copy of: The Security and Related Activities (Control) Act 1996 and the Security and Related Activities (Control) Regulations 1997 These can be obtained from the; 1. 2. State Law Publishers, 10 William Street, Perth; or On-Line at http://www.slp.wa.gov.au/Index.html

PLEASE MAKE SURE YOU HAVE READ AND FULLY UNDERSTOOD THESE INSTRUCTIONS PLEASE COMPLETE THE FOLLOWING 3 PAGE APPLICATION FORM IN YOUR OWN HANDWRITING
DISCLAIMER
PLEASE NOTE:

That your FINGER PRINTS taken as a result of this application may be compared with or put in a Forensic database, within the meaning of the Criminal Investigation (Identifying People) Act 2002; COMPLETED APPLICATIONS ARE TO BE LODGED AT Police Licensing Services Mason Bird Building, 303 Sevenoaks Street CANNINGTON WA 6107 Or if outside a 50km radius of Perth GPO, the nearest country Police Station

Form SL

WESTERN AUSTRALIA POLICE

APPLICATION FOR A LICENCE

(Security & Related Activities (Control) Act 1996)

APPLICANT MUST PERSONALLY COMPLETE THIS ENTIRE APPLICATION FORM IN BLOCK LETTERS

1 PERSONAL DETAILS
Surname

Given Names

Residential Address

Suburb

State

Postcode

Postal Address (If different to the above)

Suburb

State

Postcode

D
Motor Drivers Licence No: State of Issue

Expiry Date

Contact :
Daytime Phone Mobile Phone

Email Address

Y
Place of Birth/Country of Birth

Date of Birth

Nationality

Male

Female

Complexion

Eye Colour

Hair Colour

Height (cm)

Passport No.

D
If not Australian born please show Date and State of arrival:

D
Date

Y
State

LICENCE CATEGORY
SECURITY OFFICER INVESTIGATOR TERM OF LICENCE CROWD CONTROLLER BODYGUARD SECURITY CONSULTANT: SECURITY INSTALLER: CLASS CLASS

1 Year

3 Years

Form SL

WESTERN AUSTRALIA POLICE

APPLICATION FOR A LICENCE

(Security & Related Activities (Control) Act 1996)

APPLICANT MUST PERSONALLY COMPLETE THIS ENTIRE APPLICATION FORM IN BLOCK LETTERS

PERSONAL HISTORY
3.1 - Have you ever been refused a Security, Crowd Control or Investigator licence, or had such a licence Suspended, Cancelled or
Revoked before in Western Australia or anywhere else? - NO Type of Licence Where? Reason? If you appealed the decision, please provide full details below Court Result Date - YES Provide details below When?

3.2 - Have you ever been convicted of any offence in a court in Western Australia or elsewhere? (This includes all criminal, traffic
and childrens court convictions - include Spent convictions or charges where a conviction was not recorded) - NO Offence/Charge - YES Provide details below Court Date

3.3 Have you ever been known by any other name?

- NO - YES Provide details below

3.4 Are you a Serving member of any Police Force or Police Service? (This includes in a civilian capacity)
- NO - YES Provide details below

3.5 Employment History (Past 5 years)

Employer Period State Position

IT IS AN OFFENCE UNDER SECTION 51 OF THE SECURITY & RELATED ACTIVITIES (CONTROL) ACT 1996 TO PROVIDE INFORMATION THAT YOU KNOW TO BE FALSE OR MISLEADING.
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WESTERN AUSTRALIA POLICE

4 DECLARATION I, ------------------------------------------------

APPLICATION FOR A LICENCE

(Security & Related Activities (Control) Act 1996)

Certify that the information contained in this application has been provided by myself and that it is true and correct in every detail. I am also fully aware that it is an offence under Section 51 of the Security & Related Activities (Control) Act 1996 to provide information that I know to be false or misleading. Date

Applicants signature

Witness signature

Date

Witness, Print Name, Witnessing Authority and Contact Details

FIREARMS AND BATON ENDORSEMENT

5 ENDORSEMENT
FIREARMS BATONS

EMPLOYER DETAILS
Include all companies for which you wish to be endorsed to carry firearms - (A letter must be attached from each company that wishes to employ you in an armed capacity)

1
CORPORATE FIREARMS LICENCE NUMBER

2
CORPORATE FIREARMS LICENCE NUMBER

FIREARMS AND BATON DECLARATION I, -----------------------------------------------Certify that the information contained in this application has been provided by myself and that it is true and correct in every detail. I am also fully aware that it is an offence under Section 51 of the Security & Related Activities (Control) Act 1996 to provide information that I know to be false or misleading. Date

Applicants signature

Witness signature

Date

Witness, Print Name, Witnessing Authority and Contact Details

Form SL

Western Australia Police

SUITABILITY REFERENCE
TO THE REFEREE before you complete your reference, please read:
This Form MUST BE COMPLETED BY YOU, the Referee.

You are required to sign and date your reference document. Remember, you are accountable for what you write and sign your name to. You must provide your full name, address and contact number and you may be contacted by police to verify your statements. You must have known the applicant for a minimum of 5 years prior to the date of the licence application. This reference must NOT be less than 5 lines. Refer What must be included in a Suitability Reference? below. If you cannot comply with all of the above do not supply this reference. Referee cannot be a current serving member of WA Police or be a family member by birth or marriage (includes defacto/partner)

What must be included in a Suitability Reference?

You need to outline how you first met the applicant, what is the nature of your relationship (friend, neighbor, etc) and how long you have known the applicant. Comment and provide examples on their character (eg honesty, responsibility and integrity). This reference is about your relationship with this particular person, not his/her family or friends. Electronic knowledge such as email and chat rooms on the Internet is not sufficient knowledge.

If you do sign this document, you may be called upon to stand by this statement in an Australian Court and you may be prosecuted if you provide any false or misleading information.
To the Licensing Officer, I ___________________________________________________ have personally known the applicant
(Referees name)

____________________________________________________ for a period of ______ years______months

(Insert name YOU know the applicant by)

My relationship to the applicant. __________________________________________________________________________

________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________

Form SL

Western Australia Police

SUITABILITY REFERENCE cont.

________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________

(This section MUST be completed. If insufficient space attach separate sheet)

I declare that I am not related to the applicant by birth or marriage (includes defacto/partner relationship) I acknowledge that the particulars in this reference are true and correct and I make this acknowledgement knowing it is an offence against Section 51(1) of the Security and Related Activities (Control) Act 1996, to give information orally or in writing that the person knows to be, false or misleading in a material particular or likely to deceive in a material way. Section 51 carries a maximum penalty of $15,000.

Referee Signature: ____________________________ Referees contact details: (in block letters)

Date: ________________

Address:_____________________________________________________________________________ Phone: (Daytime) ____________________________ (Mobile) ___________________________________ Email address: _______________________________________________________________________________

Witness Signature ____________________________

Date: _________________________

Witness details (Witness must be an independent person other than the applicant or referee) Name
_____________________________________________________________________________________

Address ______________________________________________________________________________

Form SL

Western Australia Police

SUITABILITY REFERENCE
TO THE REFEREE before you complete your reference, please read:
This Form MUST BE COMPLETED BY YOU, the Referee.

You are required to sign and date your reference document. Remember, you are accountable for what you write and sign your name to. You must provide your full name, address and contact number and you may be contacted by police to verify your statements. You must have known the applicant for a minimum of 5 years prior to the date of the licence application. This reference must NOT be less than 5 lines. Refer What must be included in a Suitability Reference? below. If you cannot comply with all of the above do not supply this reference. Referee cannot be a current serving member of WA Police or be a family member by birth or marriage (includes defacto/partner)

What must be included in a Suitability Reference?

You need to outline how you first met the applicant, what is the nature of your relationship (friend, neighbor, etc) and how long you have known the applicant. Comment and provide examples on their character (eg honesty, responsibility and integrity). This reference is about your relationship with this particular person, not his/her family or friends. Electronic knowledge such as email and chat rooms on the Internet is not sufficient knowledge.

If you do sign this document, you may be called upon to stand by this statement in an Australian Court and you may be prosecuted if you provide any false or misleading information.
To the Licensing Officer, I ___________________________________________________ have personally known the applicant
(Referees name)

____________________________________________________ for a period of ______ years______months

(Insert name YOU know the applicant by)

My relationship to the applicant. __________________________________________________________________________

________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________

Form SL

Western Australia Police

SUITABILITY REFERENCE cont.

________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________

(This section MUST be completed. If insufficient space attach separate sheet)

I declare that I am not related to the applicant by birth or marriage (includes defacto/partner relationship) I acknowledge that the particulars in this reference are true and correct and I make this acknowledgement knowing it is an offence against Section 51(1) of the Security and Related Activities (Control) Act 1996, to give information orally or in writing that the person knows to be, false or misleading in a material particular or likely to deceive in a material way. Section 51 carries a maximum penalty of $15,000.

Referee Signature: ____________________________ Referees contact details: (in block letters)

Date: __________________________

Address:______________________________________________________________________________ Phone: (Daytime) ____________________________ (Mobile) ____________________________________ Email address: ________________________________________________________________________________

Witness Signature ____________________________

Date: ________________

Witness details (Witness must be an independent person other than the applicant or referee) Name Address
_____________________________________________________________________________________

_____________________________________________________________________________

Form SL

10

WA Security Industry Code of Conduct

This Code of Conduct is formulated under the provisions of Section 94 of the Security and Related Activities (Control) Act 1996 and complies with Regulation 54A of the Security and Related Activities (Control) Regulations 1997. The Code outlines the responsibilities for ALL licensees carrying out tasks relating to the provision of supplying, consultation, installation and management of security services in Western Australia. This Code of Conduct will: Promote consumer and community confidence; Improve the safety of the community and employees; Promote ethical and professional conduct; Ensure that operators comply with applicable Federal and Western Australian legislation, in particular the Security and Related Activities (Control) Act 1996 and the Security and Related Activities (Control) Regulations 1997.

Minimum Standards of the Professional Code of Conduct

Persons engaged in the provision of security or related services as detailed above shall: Conduct their professional activities with respect to and promotion of the public interest; At all times act with integrity in their dealings with the regulatory authority, clients, suppliers, employees, fellow licence holders and the general public; Not intentionally disseminate false or misleading information, whether written, spoken or implied, nor conceal any relevant fact; Maintain truth, accuracy and good taste in advertising and sales promotion; Not represent conflicting or competing interests without the express consent of those concerned and only after full disclosure of all relevant facts to all interested parties; Refrain from knowingly associating with any organisation or industry participants who use unethical, improper or illegal methods for obtaining business; Not intentionally injure the professional reputation or practice of another person; In the event that evidence is obtained relating to another licensed person being guilty of unethical practices or non compliance with the requirements of the Act or Regulations, inform either the Regulator and/or Security Industry Association of which they are a member.

I undertake to contribute to the body of knowledge for improvement of the profession by exchanging information and experience with industry participants. I acknowledge, any breach of this Code may result in disciplinary action in accordance with section 67(1a) (d) of the Security and Related Activities (Control) Act 1996.

Signature

Company

Date

----------------------------------------------------------------------------------------Name

-------------------------------------Licence Number

11
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