Reportable Conduct Scheme – City of Joondalup

Personal Details

Name(Required)

Title Given Name Family Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Work Phone

Job Title

Mobile(Required)

Email(Required)

Employment status i.e., employee, volunteer, contractor, or other (please provide details):

Categories of reportable conduct Tick relevant box(es)(Required)

Reportable Convictions

Sexual Offences

Sexual Misconduct

Physical Assault

Other prescribed offences

Report Details

Full name of employee who is the subject of the responsible allegation or conviction(Required)

First Last

Any former name or alias of the employee (if known)

First Last

Date of birth of the employee (if known)

Date of the alleged conduct or conviction (from and to) (if known)

Name of child/ren referred to in the allegation(Required)

Address of child/ren (if known)

Age of child/ren referred to in the allegation (if known)

Summary of the matters to disclose including location of alleged incident(Required)

Do you consider that the child/ren is currently at risk?(Required)

Additional information

Has the allegation of reportable conduct been reported to WA Police?(Required)

Yes

Report Number

Did any other person witness the incident?(Required)

Yes

Please provide name and contact details

I believe on reasonable grounds that an employee of the City of Joondalup has engaged in reportable conduct.(Required)

Yes

There are protections under the Parliamentary Commissioner Act 1971 for providing information under the Reportable Conduct Scheme including :

Protection from civil and criminal liability for giving information(section 30AA(3) (a)
Protection from breaches of confidentiality or professional standards (section 30AA(3) (b) and (c)
Protection from victimisation (section 30B)