Self Declaration Form

    Section 1 of 3

    Self Declaration form for a position requiring a Disclosure -- STRICTLY CONFIDENTIAL

    As an organisation we undertake to meet the requirements of the Data Protection Act 1998 and all other relevant legislation, and the expectations of the Information Commissioners Office relating to the data privacy of individuals.

    CONVICTION HISTORY

    If you have never been convicted of a criminal offence or never received a caution, reprimand or warning then please select ‘No’ below. If you have been convicted of a criminal offence, or received a caution, reprimand or warning that is now spent according to DBS filtering rules, then please select ‘No’ below. If you have an unspent criminal offence, caution, reprimand or warning (according to DBS filtering rules), please select ‘Yes’ below. For exceptions to this legislation or for more information please refer to the Rehabilitation of Offenders Act 1974 and the DBS filtering guidance.

    If yes, please give details.

    Please give details including the nature of the offences and the dates. Please give details of the court(s) where your conviction (s) were heard, the type of offence and sentence(s) received. Could you also give details of the reasons and circumstances that led to the offence(s).

    Section 2 of 3: Police Investigations

    Have you ever been the subject of a police investigation that didn’t lead to a criminal conviction (and is not subject to DBS filtering rules)?