Application Form

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What we need to know about you

Please try to complete as much of this form as you can, but don’t worry if you can’t answer everything.

1. What title do you prefer? (i.e. Mr, Mrs etc.)*

2. What is your first name(s)?*

3. What is your surname?*

4. If you have been known by a different name(s), please provide those name(s) here

5. What is your sex?*

Male

Female

6. How do you identify your gender?*

Male

Female

Prefer not to say

Self-describe

Self-describe*

7. What is your date of birth?*

DD slash MM slash YYYY

8. Do you have a disability?*

(We use this information to adapt our services to your needs.)

Yes

Prefer not to say

Details*

Are you currently in prison?*

Yes

9. What is the best postal address to reach you?*

10. If you have a telephone number, what is it?*

11. If you have an email address, what is it?*

12. Are you happy for us to contact you by email?*

We will only do so through our chosen secure email system (called Egress).

Yes

13. What is your prison number?*

14. What is the name of the prison you are in?*

15. When is your release date?*

If you do not know your release data, please enter "Unknown"

Details of friends or supporters

16. Is someone helping you with this application?*

Yes

17. If you would like us to be able to contact them, please provide us with their details:

Please provide their Name, Address, Email Address, and Phone Number

18. What is their relationship to you?*

Family, friend or supporter

Lawyer

Other

Other – please give details*

Details of solicitors

19. Who was your solicitor at trial?*

Please include their Name, Law Firm, Phone Number, and Email Address

20. Are there any other solicitors who may have papers about your case (e.g. your solicitor at appeal)? If yes please provide details.*

Please include their Name, Law Firm, Phone Number, and Email Address

What we need to know about your case

21. What crime(s) were you found guilty of?*

22. For this crime, did you tell the court you were:*

Guilty

Not Guilty

23. Was there a jury sitting in your trial?*

If you did not have a trial, please go to Question 24

Yes

24. In what town or city were you convicted?*

25. Please tick which court you were convicted in*

High Court

Sheriff Court

Justice of the Peace Court

26. What date were you convicted?*

DD slash MM slash YYYY

27. Were you convicted with other people?*

Yes

28. If yes, what were their names?*

29. What date were you sentenced?*

DD slash MM slash YYYY

30. What sentence were you given at court?*

31. Would you like us to look at your conviction for this crime?*

Yes

32. Would you like us to look at your sentence for this crime?*

Yes

Your appeal history

33. Have you asked the court for an appeal of your conviction?*

Yes

If you want us to look at your conviction, please let us know why you did not ask the court for an appeal of your conviction, using the box below.*

34. Have you asked the court for an appeal of your sentence?*

Yes

If you want us to look at your sentence, please let us know why you did not ask the court for an appeal of your sentence, using the box below.*

35. Was your appeal heard in a court?*

Yes

36. Please let us know which court your appeal was in:*

Sheriff Appeal Court

High Court

Tell us here why you think you didn’t get justice in your case

For us to refer your case back to an appeal court, we must first review all the material and then consider if there are new reasons that have not been appealed and/or grounds for it to be referred.

You will find helpful advice on how to answer this on our website. Our "Guidance on Submissions" and the documents linked to it talk about the application process and some of the more common grounds for appeal.

You can request any ofthese documents by calling us at 0141 270 7030.

37. Please tell us here why you think you should not have been convicted*

38. Please tell us here why you think the sentence imposed on you was excessive or inappropriate in the circumstances of your case*

39. Special circumstances

If you have any special circumstances which may apply in your case, please let us know here. This might be the need for interpretation or translation, your health or that of an important witness and any expected changes of circumstances such as the date of prison transfer or liberation.

40. Supporting documents*

Please let us know the documents you are sending to us with this form.

Supporting Document Files*

Drop files here or

Max. file size: 64 MB.

Data Protection

We obtain, store and disclose information about you.

We do so for a ‘law enforcement purpose’ – to decide whether there may have been a miscarriage of justice in your case and it is in the interests of justice to refer your case to the High Court for determination.

Part 3 of the Data Protection Act 2018 allows us to do so.

We may also disclose information about you for the purposes of criminal, disciplinary or civil proceedings, or the investigation or prosecution of an offence.

Our data protection and retention policies can be found at www.sccrc.org.uk – or please write to us if you would like a paper copy of the policy

How did you find out about us?*

It would help us to reach out to other people who might need the Commission if we knew how you found out about us.

Equalities monitoring

This part of the form will be detached and will not be seen by the people reviewing your application.

It would be very helpful to us if you could fill in this form. We use this form to make sure we are reaching out to as many different people as possible who may need our help. We also use this part of the form to make sure we are treating everyone equally and fairly.

Most people fill in this form, but you don't have to.

What age are you?

Please tick the appropriate box.

Under 20

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

Over 64

Prefer not to say

What sex are you?

Please tick the appropriate box.

Male

Female

Prefer not to say

What is your ethnicity?

Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you feel you belong. Please tick the appropriate box

White:

English

Welsh

Scottish

Northern Irish

Irish

British

Gypsy or Irish Traveller

Prefer not to say

Other

Any other white background, please write in:

Mixed/multiple ethnic groups:

White and Black Caribbean

White and Black African

White and Asian

Prefer not to say

Other

Any other mixed background, please write in:

Asian/Asian British:

Indian

Pakistani

Bangladeshi

Chinese

Prefer not to say

Other

Any other Asian background, please write in:

Black/ African/ Caribbean/ Black British:

African

Caribbean

Prefer not to say

Other

Any other Black/African/Caribbean background, please write in:

Other ethnic group:

Arab

Prefer not to say

Other

Any other ethnic group, please write in:

Do you have now, or have you ever been diagnosed with, a disability, that is a physical or a mental condition which has a substantial and long-term impact on your ability to do normal day to day activities?

Please tick the appropriate box

Yes

Prefer not to say

Application Form

What we need to know about you

Details of friends or supporters

Details of solicitors

What we need to know about your case

Your appeal history

Tell us here why you think you didn’t get justice in your case

Data Protection

Equalities monitoring

What is your ethnicity?

How to contact SCCRC

Send an enquiry