ONGOING DUTY OF DISCLOSURE FORM 2023/2024

All staff are required to complete this form relating to safeguarding circumstances at the start of the new academic year and at any time that their circumstances change. Should you have any queries about any of the information required or if you wish to discuss any aspect of this further, please feel free to contact HR on a confidential basis.

The following questions require you to declare if there have been any changes since your last declaration - please complete the form even where you have previously informed the school.

This form will be issued annually at the start of each academic year.

If you answer "Yes" to any of the questions below, the Head of HR and the DSL will be made aware; please feel free to talk directly to them.

Name:

School/ Department: Choose an item.

Date: Click or tap to enter a date.

CRIMINAL RECORDS

Since the date of your last self-declaration, have you been prosecuted for, received a caution for, or been convicted of, any criminal offence whether in the United Kingdom or in another country? You must disclose all spent and unspent convictions. However, you are not required to disclose a spent caution or conviction for an offence committed in the United Kingdom which is protected under the DBS filtering rules.

YES/NO* (please delete as appropriate)

Is there any relevant court action pending against you?

YES/NO* (please delete as appropriate)

SANCTIONS, RESTRICTIONS AND PROHIBITIONS

Since the date of your last self-declaration,

Are you barred from working with children?

YES/NO* (please delete as appropriate)

Are you prohibited from teaching?

YES/NO* (please delete as appropriate)

Are you the subject of a sanction, restriction or prohibition issued by the Teaching Regulation Agency, any predecessor or equivalent body in England or a regulator of the teaching profession in any other country?

YES/NO* (please delete as appropriate)

Have you been the subject of a referral to the Teaching Regulation Agency, any predecessor or equivalent body in England or a regulator of the teaching profession in any other county?

YES/NO* (please delete as appropriate)

Have you attended a hearing before a professional conduct panel where consideration was given to imposing on you a sanction, prohibition or restriction which would restrict or prevent you from carrying out teaching work, whether in England or any other country?

YES/NO* (please delete as appropriate)

Are you or the subject of a direction under section 128 of the Education and Skills Act 2008 which prohibits, disqualifies or restricts you from being involved in the management of an independent school (section 128 direction)?

YES/NO* (please delete as appropriate)

Have you been the subject of a referral to the Department for Education, or any predecessor body, so that consideration could be given to imposing a section 128 direction on you?

YES/NO* (please delete as appropriate)

Have you been the subject of a direction under section 142 of the Education Act 2002 which prohibits you from teaching, working regularly with children or from being involved in the management of an independent school?

YES/NO* (please delete as appropriate)

Are you known to the police and / or children’s social care? If in any doubt, please speak to the DSL.

YES/NO* (please delete as appropriate)

Are you or have you ever been disqualified from providing childcare?

YES/NO* (please delete as appropriate)

PLEASE COMPLETE THE DECLARATION BELOW

I confirm that the information I have given on this form is true and correct to the best of my knowledge and that I have not knowingly withheld any relevant information.

I understand that a failure to disclose information or the provision of false information, may result in disciplinary proceeding, summary dismissal and may amount to a criminal offence.

Data protection: You are required to provide the information requested in this form so that the school can meet its legal obligations. The school will process personal information in accordance with its Staff Privacy Notice.

Signed: