Name *

First Name

Last Name

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of birth *

Please note american format.

MM

DD

YYYY

Please choose the most relevant option *

I DO NOT agree to undergo any additional, necessary DBS checks.

I agree to undergo any additional, necessary DBS checks.

Disclosure of Criminal Convictions Under the Rehabilitation of Offenders Act 1974 (Amendment Order 1986) and regulations issued by the Home Office, the Trust has a duty to ensure that a Disclosure and Barring check for possible criminal convictions is undertaken for all those who apply for positions that give substantial access to children. Applicants are not entitled to withhold information about convictions which for other purposes would be ‘spent’ under the provisions of the Act. Have you ever been cautioned, convicted or found guilty of any offence by any Court (even if you were only placed on probation or conditionally discharged)? Have you ever been the subject of any investigation or inquiry into abuse or other inappropriate behavior by an enforcement agency? Answering ‘Yes’ does not necessarily bar you from appointment. Every application is considered on its own merits *

YES

NO

I am eligible to be a trustee *

Please see https://www.gov.uk/guidance/automatic-disqualification-rules-for-charity-trustees-and-charity-senior-positions for further information about who is disqualified from being a trustee.

YES

NO