If you have a disability, under the meaning of the Disability Discrimination Act 1995, please
indicate if you have particular requirements that the Court, Commission or Tribunal needs to
be made aware of.
I declare that I have a genuine interest in judicial shadowing and that the information I have
given is true. I understand that judicial shadowing will give me privileged access to
individuals and case information.
I undertake not to discuss with anyone this information, the content of any conversation I
may have with judicial office holder/s or related issues such as the lay-out of any Court,
Commission or Tribunal buildings.
I give an undertaking to immediately notify the judicial office holder, and the relevant Court,
Commission or Tribunal office should a conflict of interest (whether direct or indirect)
become apparent at any time before, during or after my placement. Should a conflict of
interest become apparent during the placement, I undertake to remove myself from the
discussion or hearing immediately.
Please sign, or type name if submitting electronically.
You can email this completed form to:
Or you can print it off and post it to:
The Judicial Shadowing Scheme Administrator
10-14 Victoria Street
Belfast BT1 3GG
Tel: 028 9056 9108
If you require this form in an alternative format please contact the JSS Administrator (details
Thank you for your interest and application.
We would appreciate it if you would also complete the Equity Monitoring Form.