Exit

As part of our duty to safeguard pupils, we need to check whether you are barred from working with children, or whether you have convictions that would make you unsuitable to work with children or in the role you’ve applied for.

Please complete the following form as accurately as possible before your interview date.

Note: you are not required to disclose convictions or cautions that are ‘protected’, as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013). If you’re not sure whether one of your convictions is ‘protected’, you can check here.

If you accidentally provide information about ‘protected’ convictions or cautions, we won’t take this into account.

We’ll use the information in this form to:

Identify whether you may be ineligible for a role based on barring or childcare disqualification requirements

Inform our conversations with you about any relevant details during the interview process

We won’t use this information to make decisions about job offers.

If we offer you a position, we’ll compare the information you’ve provided in this self-declaration with the information in your formal DBS check so that we only make decisions based on the most accurate information possible.

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* Are you barred from working in regulated activity with children (i.e., are you included on the Disclosure and Barring Service Children’s Barred List)?

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* Do you have any unspent conditional cautions or convictions under the Rehabilitation of Offenders Act 1974?

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* Do you have any adult cautions (simple or conditional) or spent convictions that are not protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020?

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* Have you committed an offence overseas which would have resulted in disqualification if it had occurred in the UK?

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* Have any orders relating to the care of children, as set out in schedule 1 of the Childcare (Disqualification) and Childcare (Early Years Provision Free of Charge) (Extended Entitlement) (Amendment) Regulations 2018, been made in respect of you?

This includes, but is not limited to:

Orders disqualifying you from caring for children

Orders disqualifying you from private fostering

Any refusal of an application for you to be registered in relation to a children’s home

Care/child protection orders issued in respect of a child in your care

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* Have you been convicted of committing, or been given a caution, reprimand or warning since 6 April 2007 for, any offences set out in regulation 4 and schedules 2 and 3 of the Childcare (Disqualification) and Childcare (Early Years Provision Free of Charge) (Extended Entitlement) (Amendment) Regulations 2018?

This includes, but is not limited to:

Any offence against or involving a child

Any sexual offence

Any violent offence, i.e. murder, manslaughter, kidnapping, false imprisonment, actual bodily harm (ABH), or grievous bodily harm (GBH)

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* Do the police or children’s social care have your name and/or   information on file for any reason?

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* If you answered 'yes' to any of the questions above, please provide further information

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* Full Name
Example: Emily Smith

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* Date of completion 
Example: 25/05/2020

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