Please fill in all the mandatory fields (marked by *)

SELF DECLARATION & BASIC DISCLOSURE FORM

 

You are being asked to complete this form because the role you are applying for is covered by the Rehabilitation of Offenders Act 1974 in England, Scotland and Wales or the Rehabilitation of Offenders (Northern Ireland) Order 1978 and involves contact with children or young people.

As the role you have applied for involves contact with children, you will also be required to undergo the relevant vetting and barring checks. 

All information you provide will be treated as confidential and managed in accordance with relevant data protection legislation and guidance. You have a legal right to access any information held about you.

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Criminal Record Declaration 

This role is covered by the Rehabilitation of Offenders Act 1974 in England, Scotland and Wales, or the Rehabilitation of Offenders (Northern Ireland) Order 1978. You are therefore only required to declare unspent conditional cautions or convictions.

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Conduct Declaration

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Confirmation of declaration
 

Please tick the boxes below and then sign this form.  

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By signing below, I confirm that the information I have provided on this form (or attached) is accurate. I understand that this information will not necessarily prevent me from being employed or appointed in the role above, and that I will be given an opportunity to discuss any concerns you might have before you make a final decision on my suitability for the role.
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