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 exempted under the Rehabilitation of Offenders Act (Exceptions Order) 1974, which means that all convictions, cautions, reprimands and final warnings on your criminal record need to be disclosed.
Please give details of offences, penalties and dates.*
*If any circumstances change which would affect your response to this question, you must inform the Human Resources department of the details without unnecessary delay.
Please read the following declaration and check the box to confirm your agreement. Failure to complete this declaration will result in your application being withdrawn.
I DECLARE THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION GIVEN ON THIS FORM IS CORRECT AND COMPLETE. I understand that any false information could result in my application being rejected or, if appointed, in my dismissal from employment. I understand that any offer of employment made to me by Coram will be subject to a check with the Disclosure and Barring Service (DBS) and I hereby give my consent to Coram carrying out the relevant DBS status check in line with the DBS Code of Practice.
I declare that I am not currently on the DBS Barred List and that I will notify the Human Resources department immediately if I do become barred in future.