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Name

First Name

Last Name

Pronouns

Date of birth

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Which trustee role are you applying for?

How would you describe your gender?

Describe your religion, spiritual believes or faith?

Do you consider yourself disabled?

How would you like to identify you ethnic identity?

Have you at any time been convicted of a criminal offence or received a Police caution and or reprimand or warning?

Rehabilitation of Offenders Act 1974 Under the Act, most sentences awarded by a Court for Criminal offences may be regarded as spent and disregarded, for most purposes, after a specified period of time and need not then be disclosed. However this post is exempt from the Rehabilitation of Offenders Act 1974 and you must therefore declare any and all convictions/cautions/reprimands/warnings you may have had. As you will be working with vulnerable individuals, prior to commencing in post you will be required to undergo a Disclosure and Barring Service check. Please note the amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are 'protected' and are not subject to disclosure to employers , and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website.

If the answer is yes, please give full details including the nature of the conviction/caution/reprimand/warning, which police force was involved, the outcome and dates.

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