PEOPLE IN ACTION DECLARATION OF CRIMINAL RECORD -page 1
Applicant's name …………………………………………………………………………..
Applicant's Address ………………………………………………………………………..
…………………………………………………………………………………………………..
As stated on the application form, because of the sensitive nature of the duties the post holder will be expected to undertake, you are required to disclose details of any criminal record.
1) Have you ever been convicted by the courts or cautioned, reprimanded or given a final warning by the police? (Note that the post you have applied for is excepted from the Rehabilitation of Offenders Act 1974, which means that all convictions, cautions, reprimands and final warnings on your criminal record need to be disclosed).
Yes/No.
If Yes, please give details of offences, penalties and dates.
(continue on another sheet if necessary)
2) Are you aware of any police enquiries undertaken following allegations made against you which may have a bearing on your suitability for this post?
Yes/No.
If Yes, please give details.
(continue on another sheet if necessary)
If you have declared a criminal record and we believe this to have a bearing on the requirements of the post, we will discuss the matter with you at interview. If we do not raise the record with you it is because we have taken the view that it should not be taken into account in deciding your suitability for the post. If you require further information or have any concerns about filling in this declaration please (continue to page 2)
