dsa_adi_37b by yanyanliu123


									ADI 37B                             (Rev. 03/10)

Application for re-registration as
an approved driving instructor (ADI)                                         Register of Approved Driving Instructors

    Stay up to date - visit us on the internet at
    Apply online at - www.businesslink.gov.uk/transport
         Business Link website contains all the latest news and
    The transportoffice website contains all the latest news and
    information essential for driver trainers and road users.

Please read the Notes for guidance before completing this form.

 Your Details                                                      1   Business Details                                               2
    Please give your criminal record disclosure reference number        Name of driving school:
    (if appropriate).

                                                                        Business address:
    Date of issue
    of Disclosure:

    Your ADI Personal
    Reference Number (PRN):

    End date of
    last certificate:


    Title:                                                              Business telephone number:
    Mr.           Mrs.     Miss          Ms.       Other

    First name(s):
                                                                       Correspondence Details                                         3
                                                                        Where would you like us to write to you?

    Home address:

                                                                        Telephone number (with area code):
    Telephone number (with area code):

                                                                        Email address:
    Mobile number:

                                                                        Which contact number and email address would you like us to
    Email address:                                                      publish on our website?

                                                                        Home             Correspondence            Do not publish
                                                                        details                   details              my details
Character Details                                                   4   Declaration                                                        6
 Have you been convicted of any
 offence within the last five years?
 (This includes fixed penalties or        Yes             No
                                                                          I declare that:
 other motoring offences, and
 non-motoring offences.
 You must also declare spent as                                            • The details given in this form are to the best of my
 well as unspent offences.)                                                  knowledge true and correct

                                                                           • I understand that if my name is kept on the Register
 Have you any endorsements
                                          Yes             No                 I must undergo tests of continued ability and fitness to
 on your licence?
                                                                             give instruction during the examiners’ normal working
                                                                             hours, and that if I do not attend such a test my
 Are any sort of court                                                       name may be removed from the Register.
 proceedings against you
 waiting to be heard?                     Yes             No
                                                                           • I understand that I must notify the Registrar of
                                                                             Approved Driving Instructors within seven days if I:
 Have you been disqualified
 from driving at any time                                                     • Change my home address or place of employment
 during the last five years?              Yes             No
                                                                                as an instructor;
                                                                              • Am convicted of any offence, including motoring
 Have you been registered as a                                                  offences, fixed penalties and non-motoring offences; or
 sex offender or disqualified from
 working with children in any way         Yes             No                  • Am registered as a sex offender or disqualified from
 in the last five years?                                                        working with children in any way.

 If the answer to any of these questions is “Yes”, please give us         If I do not, my name may be removed from the Register.
 details on a separate sheet of paper and attach it to this form.
                                                                          I apply to be re-entered on the Register of Approved Driving
 If you are disqualified from working with children, it is an offence     Instructors for a further four years.
 for you to remain on the Register of Approved Driving Instructors.

Licence Details                                                     5     If you make a false statement on purpose so that you
                                                                          keep your name on the Register, or if you give instruction
                                                                          without having an ADI licence, you may be liable for a
 Do you hold a current full                                               fine of up to £2,500.
 (not provisional) driving licence
 for a motor car, issued in Great         Yes             No
 Britain or Northern Ireland?                                             Do you agree to keep to the
                                                                          Voluntary Code of Practice*?        Yes           No
 What is the driver number on your driving licence?

 Is your licence restricted in any
 way, for example for medical
 reasons, or for a period of time?        Yes             No
 If yes, please give us details on a separate sheet.

 During your period of registration you will be required to take a
 test of continued ability and fitness to give instruction, commonly     Check list - Have you:
 known as a ‘check test’. At which driving test centre do you
 prefer to take your check test?                                            • obtained your criminal record disclosure (if appropriate)?

                                                                            • Enclosed the correct fee* or completed the payment
                                                                              slip below?

                                                                            • Enclosed one passport type photograph?

                                                                            • Written your ADI number and the date your last certificate
                                                                              ran out at the top of the form?

                                                                            • Signed the form?

                                                                         Now please return the form together with your fee and
                                                                         photograph to:

                                                                            Credit and debit card payments:
                                                                            Driving Standards Agency, The Axis Building,
                                                                            112 Upper Parliament Street,
                                                                            Nottingham, NG1 6LP

                                                                            Cheque and postal order payments:
                                                                            Driving Standards Agency, PO Box 280,
                                                                            Newcastle-upon-Tyne NE99 1FP

                                                                          * Information about the starter pack, Code of Practice
                                                                            and fees can be found on www.businesslink.gov.uk/transport
Additional Voluntary Information                                      7              ADI 37B - Notes For Guidance
   You do not have to complete this section
                                                                                     Contact us if          Tel:      0300 200 1122
   Release of Information:
                                                                                     you have any           Email:    adireg@dsa.gsi.gov.uk
   Outside organisations often ask us for the names and addresses                    queries:
   on our database. Before we can supply this information, we are
   obliged under the Data Protection Act 1998 to ask for your
   consent. If you give your consent, we would make it a condition                   Please note: this form should be used only when applying for
   that organisations would not, in turn, sell it to anyone else.                    re-registration within 12 months of your last certificate running out.
                                                                                     If your certificate is still valid you should apply for an extension of
                                    I agree to give my consent                       registration online at www.businesslink.gov.uk/transport or
                                                                                     by using form ADI 37A.

   Equality and Diversity:                                                           If your last certificate ran out more than 12 months ago you will
                                                                                     have to pass the qualifying tests again. You can apply to do this
   We recognise and value diversity. We want to ensure all eligible                  online at www.businesslink.gov.uk/transport or by using form
   applicants are considered with respect to their own ability and                   ADI 3, which is included in our starter pack for ADI. You can buy a
   which is not influenced by other factors. To help us to do this
   effectively we need to monitor our policies and procedures.                       starter pack by ringing 0300 123 1126 and paying by credit/debit
                                                                                     card, or writing to the
   Please tick the box which most applies to you.
                                                                                     Driving Standards Agency, The Axis Building,
                                                Mixed Caribbean
                      Arab                            and White
                                                                                     112 Upper Parliament Street, Nottingham, NG1 6LP.

                                                                                     Cheques and postal orders should be crossed and made payable
               Bangladeshi             Other Asian background                        to the Driving Standards Agency. Please visit
                                                                                     www.businesslink.gov.uk/transport to check the correct
                                                                                     price, or contact us by phone or email.
              Black African            Other Black background
                                                                                     Payment will be taken from your account as soon as your
                                                                                     application has been received. This does not indicate that your
        Black Caribbean                Other ethnic background                       application has been successful. If it is refused we will issue you
                                                                                     with a full refund.

                  Chinese                  Other mixed ethnicity                     Criminal Record Check
                                                                                     You will usually need to have a criminal record check before
                                                                                     you submit this form.
          Gypsy/Irish or               Other White background
        Scottish traveller
                                                                                     You should ring us to let us know that you intend to re-register
                                                                                     after that date and require a criminal record disclosure. We will
                     Indian                            Pakistani
                                                                                     then arrange for our contractor, TMG CRB, to send you a disclosure
                                                                                     application form and guidance on how to complete it. The form
Mixed African and White                             White British                    should then be returned to them. When they have checked it to
                                                                                     make sure it is completed properly, they will send it to either the
                                                                                     Criminal Records Bureau if you normally live in England or Wales, or
  Mixed Asian and White                         Prefer not to say                    Disclosure Scotland if you live in Scotland. A criminal record report,
                                                                                     or disclosure, will then be sent to you and a copy to our contractor,
                                                                                     who will forward it to us.
Mixed Asian background

                                            Gender         Male


                                                                                                                                   (continued over the page)

Please do not detach slip                  I wish to pay by Visa / Mastercard / Delta.                 Name of card holder:
                                                               (delete as appropriate)

                                           Please charge     £                    to my account
My card number is:

Start Date:                      Expiry Date:

                                                                  Issue Number:

If paying by credit/debit card I agree that any refund be made to the card holder
                                                                                                       Signature of card holder:
Signature of                                                            Date:
  ADI 37B - Notes For Guidance (continued)

You do not need to send us your copy of your disclosure - all you       Ethnic Origin
need to do is write its reference number in the box on this form.
                                                                        We recognise and value diversity. We want to make sure that we
Please apply for your disclosure in good time. It may take many         consider equally everyone who applies to be an ADI with respect
weeks for it to be provided to you, and then we will need time to       to their own ability whatever their race, nationality, ethnic origin,
consider your application.                                              gender identity, sexual orientation, marital status, age, disability,
                                                                        religion or belief. We want to make sure that this policy is working
Please note: If you have any endorsements or more than 3 fixed          and take steps to make sure that we make progress within the
penalty points on your licence you should contact us, by phone          equality and diversity field.
in the first instance, before applying for your disclosure. We will
then advise you what you should do next.                                To do this we need you to answer the questions in this section.
                                                                        Your answers will in no way influence your application to become an
Having a criminal record will not necessarily bar you from              approved driving instructor as long as you meet the qualifying criteria.
being accepted as an Approved Driving Instructor. Please read
our statement on the suitability of ex-offenders to apply to join the   We will keep this information confidential and only use it for
Register of Approved Driving Instructors. This, and our statement       monitoring purposes. We will store this information on our
on how we handle disclosure information, is available on our            electronic document archive and ADI Register database.
website above.
                                                                        Processing your personal data
DSA complies fully with the Criminal Records Bureau and
Disclosure Scotland Codes of Practice. Copies of these are              The Driving Standards Agency (DSA) directly manages all personal
available on request from DSA, or from the                              data it processes as an executive agency of the data controller, the
www.crb.homeofficegov.uk and                                            Department for Transport.
www.disclosurescotland.co.uk websites.
                                                                        We use the personal data you give us to help run the Register of
So that we can assess if you continue to be a “fit and proper”          ADIs and practical driving test. We also use your details for statistics
person, you must tell us about any motoring or non-motoring             and analysis to assess equality and improve our customer service.
offences (including fixed penalties and cautions) that you may have
been convicted of or awarded in the last five years. We are entitled    We must ensure the integrity of the driving test. We may use the
by law to ask you to declare spent as well as unspent convictions.      personal data you supply for the purposes of preventing or detecting
                                                                        crime and catching or prosecuting offenders. This may include hidden
Section 6: Additional voluntary information                             monitoring when appropriate.

You do not have to complete any part of this section.                   We do not disclose or share personal data with any third parties other
                                                                        than in line with the Data Protection Act 1998. This may include, but is
Release of Information                                                  not restricted to, disclosure to the police, HM Revenue and Customs,
                                                                        local governments and DVLA. In the case of transfers from DVLA, this
We are frequently approached by outside organisations, asking for       may include details of endorsements for the purpose of ensuring that
the names and addresses on our database. Before we can supply           registered ADIs continue to be fit to remain on the register.
this information, we are obliged under the Data Protection Act 1998
to ask for your consent. An example of this would be third parties      For further information, please see our website www.dsa.gov.uk
wanting to send marketing information. If you give your consent,        or look for our Notification Document on the Information
we would make it a condition that organisations would not, in turn,     Commissioner’s website www.ico.gov.uk. Our registration number
sell it to anyone else.                                                 is: Z7122992.

Please tick the box on the previous page if you are happy for us to
release your name and address to any company or organisation.
You shouldn’t tick the box if you don’t want us to release your
name and address to any company or organisation. We will still
send important information to you.

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