Name:

TACT’S SAFEGUARDING DECLARATION FORM

UK legislation and guidance relating to the welfare of children has its core principle that the welfare of children and young people must be the paramount consideration. TACT fully support this principle and therefore require that people who come into contact with children or young people or personal details of children, complete and sign this declaration. This is to ensure that children and young people’s welfare is safeguarded. This self declaration will be kept for the duration of your employment with the TACT.

Due to the nature of this post this work is exempt from the provisions of Section 4 (2) of the Rehabilitation of Offenders Act 1974. You are therefore asked to disclose whether you have any unspent convictions, cautions, reprimands, or final warnings on your criminal record. Enhanced disclosures are sought for all posts involving greater contact with children or vulnerable adults, for example; jobs involving caring, supervising, training and being in sole charge of children and vulnerable young adults. These will be sought in respect of all social work and support work posts. I understand that an enhanced disclosure will be sought in the event of a successful application and I hereby give my consent and on-going consent (if part of the Disclosure and Baring Service Update) to TACT processing criminal records checks. Please be honest in your response.

  1. Has any Social Services Department or Police Service ever conducted an enquiry or investigation about any allegations or concerns that you may pose an actual or potential risk to children or young people?

YESNO

If yes, please specify

  1. Have you ever become convicted of any offence relating to children or young people?

YESNO

If yes, please specify

  1. Have you ever been the subject of disciplinary procedures or been asked to leave employment or voluntary activity due to inappropriate behaviour towards a child or young person?

YES NO

If yes, please specify

  1. Are there any other matters which may inhibit or otherwise affect your ability to work with children, young people or vulnerable young adults?

YESNO

If yes, please specify

  1. I confirm that I understand that any action which places a young person at risk, or that could lead to placing myself or TACT in a potentially compromising situation, or making or responding to an attempt at inappropriate contact, may be treated as a disciplinary matter which could lead to dismissal.

Yes

This declaration must be signed and returned to the HR Department at the address below or emailed to ior to interview with TACT.

I confirm that the above information given by me is correct and that I consent to my personal data being processed and kept for the purpose described above in accordance with the Data Protection Act 1998.

Name:
Signature:
Date:
Position applied for:

Please return this form to the HR Department, marked Strictly Private & Confidential, at TACT, The Courtyard, 303 Hither Green Lane, London SE13 6TJ. Or email to:

Please note: At interview, or under a separate discussion, we undertake to ensure an open and measured discussion on the subject of any offences or other matters that might be considered relevant for the position or work concerned. The Recruiting/Line Manager will complete a Risk Assessment form to assess the relevance of the criminal record and this will be kept on a separate file in a secure, lockable filing cabinet for the duration of your employment.

Signature of Recruiting/Line Manager:
Date:
Recruiting/Line Manager Notes from interview/separate discussion:

Note to HR: Form to be kept with TACT application form if clear. If not, to be kept on separate CRB/PVG File.

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