ࡱ>  Cbjbjss |Hp L\lll8L<=>X@lMd4t=v=v=v=v=v=v=$@GCV=]l=ll=///llt=/t=//608D::Qhmd9`= >0=>,9C^C8D:ClD:/==/=>C :  MODEL REHABILITATION OF OFFENDERS ACT 1974 DISCLOSURE FORM This disclosure form is supplementary to the relevant section relating to the Rehabilitation of Offenders Act 1974, of the relevant CES model Application Form. Where you are making an application in writing, this form must be completed and sent in a separate, sealed envelope marked confidential and returned with your completed Application Form and any other supplementary or supporting documents. In accordance with statutory requirements certain pre-employment checks are conducted for positions that involve work with vulnerable groups, specifically children and vulnerable adults. The information obtained from these checks is used to help safeguard these groups. It will not be used to discriminate unfairly against those with convictions which we consider unrelated to working with vulnerable groups. Having a criminal record will not automatically bar you from employment or voluntary work with us. As the position you are applying for gives you privileged access to vulnerable groups, you are required to disclose all spent convictions and cautions under the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975 unless it is a protected conviction/caution under the amendments made to the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975 (in 2013) and, therefore, not subject to disclosure. This means that you must disclose spent and unspent convictions on this form other than those which are so protected. This may include any driving offences. Guidance on the filtering of protected convictions and cautions can be accessed on the Disclosure and Barring Service website. Failure to disclose any disclosable criminal convictions could lead either to your application being rejected or, if you are appointed, to dismissal if it is subsequently discovered that you have had any criminal convictions. It is a criminal offence to apply for a position working with children if you are excluded from doing so. Failure to complete this form may render your application invalid. Full Name:  FORMTEXT       Date of Birth: FORMTEXT       Post Applied for: FORMTEXT       Please check the appropriate box to indicate whether you have any convictions, cautions, reprimands or final warnings that are not protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013): No:  FORMCHECKBOX  Yes:  FORMCHECKBOX  If you have answered yes to the question above, please set out the details below:- Date of Conviction/pending Hearing/Caution/Reprimand/WarningOffenceSentenceDetails of Police/Court involved FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        Declaration: I hereby certify that the information given above is true and accurate: SIGNATURE :  FORMTEXT       DATE :  FORMTEXT       YOUR PERSONAL DATA In compliance with the General Data Protection Regulation (GDPR), we wish to ensure you are aware of the purpose for which we will collect and process the data we have asked you to provide on this disclosure form. Please see the privacy statement below. Privacy Notice: Important Information Regarding Your Data 1. We are  FORMTEXT St Gregory's Catholic Science College, our address is Donnington Road, Kenton, Middx. HA3 0NB. We are a VA Academy that is part of the All Saints' Trust. The Academy Trust is the data controller and the school is part of the Academy Trust Company. . 2. To the extent that you have disclosed any criminal record information on this form, your information may be shared with OFSTED and the Local Authority Designated Officer for child protection matters (the LADO). As a Catholic education provider, we work closely with  FORMTEXT The Diocese of Westminster with whom we may be required to share the information you have provided on this form. 3. The person responsible for data protection within our organisation is  FORMTEXT Mr Matt Lantos and you can contact them with any questions relating to our handling of your data. You can contact them by  FORMTEXT emailing him at dpo.lantos@bsp.london. 4. We require the information requested on this form in order to process your application for employment and to ascertain whether you are a suitable candidate to work with children/in a child centred environment. 6. We require you to complete this form regarding criminal record disclosure as the information is needed in order to comply with our legal obligation to safeguard and protect children from harm. 7. If your application is successful and you have disclosed criminal record information on this form, we shall retain the form as part of your permanent employment record and afterwards in accordance with the Schools data retention policy. In addition, we shall document and retain records of relevant guidance/advice received by OFSTED and/or the LADO and any other appropriate third party. 8. If you are unsuccessful and you have disclosed criminal record information which could disqualify you from working with children/in a child centred environment, we shall share the information you have provided on this form with OFSTED and/or the LADO and any other appropriate third party. 9. If you are unsuccessful and you have not disclosed criminal record information on this form, this form shall be destroyed after a maximum period of 6 months.  ?@ n o p ±sfUGU6 hDLhDLKHOJPJQJ^JhDLh6JvOJQJ\^J hDLh6JvKHOJPJQJ^Jh6JvhDLOJQJ^JhDLKHOJPJQJ^J h6JvhDLKHOJPJQJ^J h6JvhDLOJQJ^JmH sH h6JvOJQJ^JmH sH  h6Jvh6JvOJQJ^JmH sH htVhNmH sH hshNmH sH hNmH sH hf>*mH sH +jh]hO 5UmHnHsH tH u?@ o p }}$a$gd6Jv#$ & F 7d1$5$7$8$H$^`a$gd6Jv$d1$5$7$8$H$a$gdDL#$ & F 7d1$5$7$8$H$^`a$gdDL$$d ha$gd6Jvgd]Ll$gdNgdy t \^`vx"$8:<FHҬҔ{Ҭc{ҬK{Ҭ/j~^h6Jvh6JvOJQJU^JmH sH /j ^h6Jvh6JvOJQJU^JmH sH 0jh6Jvh6JvOJQJU^JmHnHsH u/j]h6Jvh6JvOJQJU^JmH sH )jh6Jvh6JvOJQJU^JmH sH  h6Jvh6JvKHOJPJQJ^J h6Jvh6JvOJQJ^JmH sH h6Jvh6Jv5OJQJ\^Jh6Jvh6JvOJQJ^J\^`X)fnw$$d h$Ifa$gd6Jv$$d h^a$gd6Jv$a$gd6Jv$d1$5$7$8$H$a$gd-$$d ha$gd6Jv  &}eL}}0jh6JvhaOJQJU^JmHnHsH u/jy`h6JvhaOJQJU^JmH sH  h6JvhaOJQJ^JmH sH )jh6JvhaOJQJU^JmH sH  h6Jvh6Jv/jf_h6Jvh6JvOJQJU^JmH sH )jh6Jvh6JvOJQJU^JmH sH /j^h6Jvh6JvOJQJU^JmH sH  h6Jvh6JvOJQJ^JmH sH :d^IIII$$d h$Ifa$gd6Jvkd_$$Ifl\'^'#Ms t0644 laytK&(*468:<PRT^`bdfz|~ҹҨҨҹҨҨgҹҨ`ҨHҹ/jbh6JvhaOJQJU^JmH sH  h6Jvh6Jv/jah6JvhaOJQJU^JmH sH /jaah6JvhaOJQJU^JmH sH  h6Jvh6JvOJQJ^JmH sH  h6JvhaOJQJ^JmH sH 0jh6JvhaOJQJU^JmHnHsH u)jh6JvhaOJQJU^JmH sH /j`h6JvhaOJQJU^JmH sH 8^IIII$$d h$Ifa$gd6JvkdIb$$Ifl\'^'#Ms t0644 laytK  $&(2468:<ٰg`Sh6Jvh6JvOJQJ^J h6Jvh6Jv/jDdh6JvhaOJQJU^JmH sH /jch6JvhaOJQJU^JmH sH 0jh6JvhaOJQJU^JmHnHsH u/j\ch6JvhaOJQJU^JmH sH  h6Jvh6JvOJQJ^JmH sH  h6JvhaOJQJ^JmH sH )jh6JvhaOJQJU^JmH sH 8:<*dfh^YYQYYYYY$a$gd6Jvgd6Jvkdd$$Ifl\'^'#Ms t0644 laytK <&(*<>RTV`bdJKҧҗҧuaVK=Vh6Jvh6Jv5>*CJaJh6Jv5>*CJaJh6Jvh6JvCJaJ&h6Jvh6Jv56CJOJQJ^JaJh6Jvh6Jv>*OJQJ^J'jeh6Jvh6JvOJQJU^Jh6Jvh6Jv6OJQJ]^J,jh6Jvh6JvOJQJU^JmHnHu'jWeh6Jvh6JvOJQJU^J!jh6Jvh6JvOJQJU^Jh6Jvh6JvOJQJ^Jh6Jvh6Jv5OJQJ\^JIJK)*23  _` +!,!@@BB gd6Jv $da$gdDLgd6Jv $da$gd6Jv8tuƽƢs_VNhnA`CJaJ *hmb\CJaJ&jf *hnA`hnA`CJUaJ *hnA`hnA`CJaJ j *hnA`hnA`CJUaJ h6Jvh6Jvh6Jvh6JvCJaJ" *hnA`hnA`CJaJmHnHu *h0BCJaJ *hM`cCJaJ *hmb\CJaJ&j?f *hnA`hnA`CJUaJ *hnA`hnA`CJaJ j *hnA`hnA`CJUaJ  /0\] ,!@@AAAAAA B BBʿ۳ۖۿ|ogWoRMo| *h0B *hMjh *hnA`hnA`U *hnA`hnA`j *hnA`hnA`U h6Jvh6JvU jh6Jvh6JvCJH*UaJ *hPCCJaJ&jg *hnA`hnA`CJUaJ *hnA`hnA`CJaJh6Jvh6JvCJaJhnA`CJaJ *hmb\CJaJ j *hnA`hnA`CJUaJ&j'g *hnA`hnA`CJUaJ10. If you fail to complete this form we will not be able to comply with our legal duty to safeguard children and cannot therefore continue to process your employment application or offer you a position within our organisation. 11. To read about your individual rights and/or to complain about how we have collected and processed the information you have provided on this form, you can make a complaint to our organisation by  FORMTEXT  via our academy Complaints Procedure which is available on our Academy website. If you are unhappy with how your complaint has been handled you can contact the Information Commissioners Office via their website at: ico.org.uk  See paragraph 2.  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