GARDA YETTING APPLICATION FORM NOTE TO APPLICANT - IABA

An Garda Siochdna
Reference No:
An Garda Sioch6na
GARDA YETTING APPLICATION FORM
NOTE TO APPLICANT
-The Enquiry Form must be completed in full using BLOCK CAPITALS
(Please state N/A if details are not applicable)
-Writing must be clear and legible
-Return the completed form to Mr Larry Morrison,Irish Amateur Boxing
Association, National Stadium, South Circular Road, Dublin I
-Do not send this form to The Garda central vetting unit or to any Garda
Station
To be completed by the applicant
SgRNAMEJ P H EV I o USil AM E L i [f..'.Eh ]r
FORENAME!
ALIASiI
PPSNO:
OATEaF B}R+HTilii/mriiiriiv):
nA]v-E-YOu:EvEB 0.E! NGEb y.oxR NAue
(if yes, please state former name) :
6'bN-AG+} r U f P g,O l,t F'NO :
hJp:use,
iL N. 'i.;.ii,
= i ilt!i:,
ebuntilli
Postr
Codb
e6Uhtrv
Year.
FfOm
Year
-To

Have you ever been convicted of an offence in the Republic of Ireland or
elsewhere (please tick) No Yes _ Please Provide Details
il;ni5ATE COURT OFFENCE COURT.OUTCOME
DECLARATION OF APPLICANT
l, the undersigned who have applied to work as a hereby
authorise An Garda Sfoch6na to furnish to lrish Amateur Boxing Association a statement
that there are no convictions recorded against me in the Republic of lreland or elsewhere, or
a statement of all convictions and / or prosecutions, successful or not, pending or completed,
in the State or elsewhere as the case may be.
Signature of Applicant:
Date:
Club Name:
Contact no:
Authorised Signatory:
(rABA)
Registration Number:
-!;'6==*lb.lii o-m.. .'ti5.1,,!lib..y.th.e..l,lGl idd-:c.=e-.lmirvetilnE.:unii
According to Garda records there are no previous convictions recorded against the above
named applicant:
OR the attached convictions appear on Garda Records:
OR the attached prosecutions are pending:
NOTE: Checks were carried out by this off ice based on the information supplied.
The convictions supplied may apply to the subject of your enquiry.
Please verify information disclosed with the applicant.
Signed:
Member yc ,le.V.[]

VETTING IDENTIFICATION CARD .
COMPULSARY
Along with your vetting form, please send 2 passport type photographs and a €10 card fee in
the form of a cheque, bank draft or postal order, made payable to IABA
When you are fully vetted by An Garda Siochana, you will be issued with an IABA Garda
approved vetting identity card. This is to confirm your vetting status and can be used at
competitions.
Please send your completed vetting form, photographs and card fee to:
Mr Larry Morrison
IABA
National Stadium
145 South Circular Road
Dublin 8