(CRB) Disclosure Form - Faculty of Health, Social Care and ...
(CRB) Disclosure Form - Faculty of Health, Social Care and ...
(CRB) Disclosure Form - Faculty of Health, Social Care and ...
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FACULTY OF HEALTH AND SOCIAL CARE SCIENCES<br />
School <strong>of</strong> <strong>Social</strong> Work<br />
Criminal Records <strong>Disclosure</strong> <strong>Form</strong><br />
<strong>Social</strong> Work <strong>and</strong> Probation are exempt from the provisions <strong>of</strong> the Rehabilitation <strong>of</strong><br />
Offenders Act. This means that you must declare any criminal convictions, cautions,<br />
warnings, final warnings or bind overs, even if they are spent. I need to ask you<br />
therefore, to tell me <strong>of</strong> any convictions, cautions, reprim<strong>and</strong>s, final warnings or bind<br />
overs that you have. CANDIDATES WHO DO NOT DISCLOSE OFFENCES WHICH<br />
COME TO LIGHT LATER as a result <strong>of</strong> an enhanced Criminal Records Bureau<br />
disclosure, or prior to a placement, are likely to be subject to the University disciplinary<br />
proceedings which may lead to their having to withdraw from the course.<br />
The <strong>Faculty</strong> <strong>of</strong> <strong>Health</strong> <strong>and</strong> <strong>Social</strong> <strong>Care</strong> Science will organise an enhanced <strong>CRB</strong><br />
<strong>Disclosure</strong> for all social work students. There is a charge.<br />
Name:<br />
………………………………………………………………………………………………..<br />
Date:<br />
………………………………………………………………………………………………….<br />
Course applied for:<br />
………………………………………………………………………………....<br />
Have you any spent / unspent convictions, cautions, reprim<strong>and</strong>s or final warnings,<br />
been bound over, have prosecutions pending or been disqualified from working with<br />
children by an order under the Criminal Justice & Court Services Act (2000)?<br />
□ NO<br />
□ YES Please provide details below.<br />
DATE COURT OFFENCE DISPOSITION<br />
Signed:<br />
Date:
For University Use Only<br />
Interviewers’ comments:<br />
Please add comments below concerning any declared criminal conviction discussed at<br />
interview:<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
Name<br />
(Please print)<br />
Signature<br />
Name<br />
(Please print)<br />
Signature<br />
Admissions Tutor’s decision regarding criminal conviction or proceedings – are they acceptable for<br />
registration purposes?<br />
ACCEPT<br />
REJECT<br />
Other comments:<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
……………………………………………………………………………………………………………..<br />
Signature<br />
Date:<br />
2
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