DBS — Southend Musical Festival

DBS Form for Staff ad Volunteers

Declaration from all staff and volunteers working with children or Vulnerable Adults where an Enhanced DBS check is required for the role.

The Federation has a Policy on the recruitment of ex-offenders which is available on request.

Do you have any convictions, cautions, reprimands or final warnings which would not be filtered in line with current guidance?

Yes

No

If yes, please state below the date(s) and nature of the offence(s):

Name

First Name

Last Name

Date

Any surname previously known by:

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email address

Home Telephone

Mobile Telephone

Place of birth

Date of birth

Signed

By checking this box you sign your name

Signed

You are advised that, under the provisions of the Rehabilitation of Offenders Act (UK wide) (1974) (Exceptions) (Amendments) Order 1986 (UK wide). The Scotland Amendment Order 2013 and the Rehabilitation of Offenders (Northern Ireland) Order 1978 and the Police Act 1997 you should declare all convictions, including spent convictions. You are further advised that it is a criminal offence to seek employment working or volunteering in a regulated or controlled position with members of vulnerable groups, including children, if you are disqualified from doing so. To make a false declaration on this form will be considered an attempt to do so. (If you fail to mention

DBS Form for Staff ad Volunteers

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