Declaration Form for Job Applicants
Please complete this form to provide required declarations regarding relationships, disciplinary proceedings, and criminal records as part of your job application.
Full Name
*
First Name
Last Name
Declaration of Family/Close Relationships
Do you, to the best of your knowledge, have any family or close relationships to existing service users, employees, or Trustees of Mid Norfolk Mencap?
Please select the appropriate statement:
*
I have none to declare
I have information to declare, and I will attach details.
If you have information to declare, please attach details here (optional):
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Declaration of Disciplinary Proceedings
Are you currently or have you previously been involved in disciplinary proceedings with a current employer, or whilst working with vulnerable people?
Please select the appropriate statement:
*
I have none to declare
I have information to declare, and I will attach details below.
If you have information to declare, please attach details here (optional):
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Criminal Record Declaration
Mid Norfolk Mencap is committed to safeguarding vulnerable adults and requires an enhanced DBS check for all staff. Certain convictions and cautions are considered 'protected' and do not need to be disclosed. Please refer to Ministry of Justice guidance if unsure.
Please select the appropriate statement:
*
I have none to declare
I have information to declare, and I will attach details below (please detail any criminal convictions except those 'spent' or 'protected').
If you have information to declare, please attach details here (optional):
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Please sign below to confirm that the above information is accurate at the time of completing this form.
Submit Declarations
Submit Declarations
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