Wessex 4x4 Response

Membership application and update Form

DATA PROTECTION ACT:
Members are reminded that information given on this form will be kept on a computerised Database solely for 4x4 Response purposes.
These include any statutory checks that we may be required to undertake to ensure compliance with legislation.
Members are reminded that under the terms of the Data Protection Act they may not disclose any priviledged information given to them as a result of their membership of Wessex 4x4 Response Association.

Use this form to apply for Operational or Support/ non-operational membership.

Both types of membership are equally important and incur a joining fee of £10 plus a membership fee of £10 per annum i.e £20 in the first year.
Upon acceptance, you will be issued a photographic ID card, vehicle identification and other equipment depending upon your role whch you agree to carry and use as appropriate whenever on duty as a member of Wessex 4x4 Response.
Potential members are advised that at times the tasks carried out by members may require physical exertion, therfore you should be reasonably fit and capable of physical work.
Any issued items must be returned upon termination of membership or at any time when requested to do so by an officer of the organisation.
Any material changes to the information which you enter below must be advised to the membership secretary by resubmission of this form


Do you understand that failure to display appropriate identification and follow Health and Safety guidance, or failure to notify material changes to the information below may result in cancellation of membership?
Have you read and understood the advise to members?:
Have you read and understood the DPA statement at the top of this page?:
Do you understand that deliberate falsification of information may result in cancellation of your membership

If you answer N to any of the above; you will be contacted prior to being accepted.

Are you a barred individual under the Safeguarding Vulnerable Groups Act 2006?
Do you have any objections to us carrying out our statutory checks under this legislation Safeguarding Vulnerable Groups Act 2006?

If you answer Y any of the above 3 questions; you will be contacted prior to being accepted.

Wesssex 4x4 Response is an equal opportunities group and does not discriminate on grounds of race, sex or sexual orientation, age other than a minimum age of 18, or disability, however any illness/ disability or criminal conviction which may impact on your ability to carry out duties on our behalf should be declared.

Do you have any Illnesses or disabilities which we should be aware of? If you answer Y please specify
Do you have any unspent convictions If you answer Y please specify
The declaration of a conviction or disability does not necessarily preclude membership which we will discuss fully with you before making any decision.

Are you an existing member who wishes to change some details?:

  • Date of Birth dd/mm/yyyy
  • First Name
  • Known As
  • Surname
  • House No.or Name
  • Street etc.
  • Address 2
  • Town
  • County
  • Postal Code
  • Home Tel
  • Mobile No.
  • E-mail Address
  • Alternative E-mail
  • Amateur Radio Call Sign (if held)
    • We ask details of someone to contact should you be out longer than anticipated. (including support members).
  • If the need should arise please contact my (state Relationship i.e partner /employer /family member)
  • Whose name is
  • Their Landline is
  • Their mobile is

  • Membership type applied for Operational Support

    • Those applying for support membership may proceed to the end and click 'submit'
    More Information about yourself
    Hi Vis clothing sizes
  • Jacket size
    Small
    Medium
    Large
    XL
    XXL
  • Trouser size
    Small
    Medium
    Large
    XL
    XXL
    XXXL

  • First Aid qualifications
    None
    Basic (FAW or similar)
    Intermediate (Semi-professional)
    Advanced (Paramedic, Mid-wife, Dr etc)

  • General Qualifications or Attributes which may be relevant to our operations

    • Driving experience
  • Off Road Experience
    None
    Basic
    Intermediate
    Advanced

  • Off Road Qualifications
    None
    BORDA
    LANTRA
    Other

    • On road qualifications
  • Driving Licence type
    None
    Provisional
    Bike only
    Full Car
    HGV
    PSV
    Other


    • Members who wish to drive on our behalf must have held a licence for at least 3 years and have no more than 6 penalty points.
  • Years Held
  • How many points currently
  • On Road achievements /higher qualifications i.e. IAM, ADI, Police advanced etc.
    • Vehicle details
  • Vehicle Make
  • Vehicle Model
  • Number of Seats INCLUDING driver ?

  • Rear Recovery Point
    Yes
    No

  • Front Recovery point
    Yes
    No

  • Winch
    Yes
    No

  • Tow bar
    None
    Ball
    Pin
    Combined
    NATO

  • OS Maps for the likely area of ops
    Yes
    No

  • SATNAV
    Yes
    No

  • Basic vehicle tools
    Yes
    No

  • Suitable First Aid Kit i.e. 10 man
    Yes
    No

  • CB Radio
    Yes
    No
  • Amateur Radio -2 Metre minimum
    Yes
    No

  • Self recovery equipment
    Hi Lift
    Shovel
    Tow rope/Strop
    Snow Chains
  • Other useful equipment

  • Trailer
    No
    Yes

  • Trailer Details i.e Length x Width + capacity in Kgs

    • Please enter the code below in the box and click submit to complete your application. If you wish to change the letters please click the blue recycle arrow.

    Upon acceptance we will require a passport style photo either by post or as a Jpeg file, this is for your membership card. and the application/membership fee.
    Copyright © 2008  Wessex 4x4 Response Association
    All rights reserved.
    Revised: 30/10/08