Criminal Record Declaration Form For Jobs Covered by The ROA

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Criminal record declaration form for jobs covered by the ROA

You have been asked to complete this form because the role you have applied for is
covered by the Rehabilitation of Offenders Act 1974. The information disclosed on
this form will not be kept with your application form during the application process.

Policy statement on recruiting applicants with criminal records

This post is covered by the Rehabilitation of Offenders Act 1974 and therefore
applicants are required to declare:

 Unspent convictions and/or unspent conditional cautions only

For further information on how long it takes for convictions and conditional cautions
to be spent, please refer to Nacro’s guide on the Rehabilitation of Offenders Act.

We recognise the contribution that people with criminal records can make as
employees and volunteers and welcome applications from them. A person’s criminal
record will not, in itself, debar that person from being appointed to this post. Any
information given will be treated in the strictest confidence. Suitable applicants will
not be refused posts because of offences which are not relevant to, and do not place
them at or make them a risk in, the role for which they are applying.

All cases will be examined on an individual basis and will take the following into
consideration:

 Whether the conviction is relevant to the position applied for.


 The seriousness of any offence revealed.
 Your age at the time of the offence(s).
 The length of time since the offence(s) occurred.
 Whether the applicant has a pattern of offending behaviour.
 The circumstances surrounding the offence(s), and the explanation(s) provided.
 Whether your circumstances have changed since the offending behaviour.

It is important that applicants understand that deliberate attempts to conceal the


information requested in this form could result in disciplinary proceedings or
dismissal. Further advice and guidance on disclosing criminal records can be
obtained from Nacro’s Criminal Record Support Service.
Criminal record declaration form
If you are unsure about how to answer the questions on this form, please contact Nacro's
Criminal Record Support Service on 0300 123 1999 or [email protected]. All
enquiries to this service are confidential. You will not be asked for any personal details,
unless you want information or advice sent to you.

Surname: First name:

Do you have any unspent convictions or conditional cautions?

Yes  No 

If you have answered yes, you now have two options for disclosing your criminal record.

Option 1: You can disclose your criminal record on a separate sheet provided that you mark a
cross on the line below and attach the details in an envelope stapled to this form. The envelope
should be marked CONFIDENTIAL and state your name and details of the post.

I have attached details of my conviction separately_____ (please mark with an X if appropriate.)

Option 2: Please provide details in the space below.

DECLARATION

I declare that the information provided on this form is correct. I understand that the
declaration of a criminal record will not necessarily prevent me from being offered this role
at Faith PS Ltd.

Signed: Date:

Please return this form to: James Montgomery, HR Coordinator

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