Recruitment Disclosure Form


Please read the Policy Statement at the end of this form. The Statement explains why we are asking you questions about any criminal convictions and how any information you give will be used and verified.

The role you have applied for involves contact with vulnerable groups / close and unsupervised access with vulnerable groups, i.e. people with learning disabilities, therefore in accordance with the Rehabilitation of Offenders Act, 1974, you are asked to provide details of all unspent convictions

All applicants who are offered employment will be subject to a criminal record check from the Disclosure and Barring Service or DBS Update Service Status check (if applicable) before their offer of employment is confirmed. If you subscribe to the DBS Update Service please let us know as you will also need complete the DBS Update Service Form to give us consent to carry out the Status check and Certificate details.


Do you have any unspent convictions, cautions, reprimands or warnings?
Please make sure you include any driving offences when answering the above, even though these may be minor.
If you have answered yes to this question, please provide details below: You are invited to give any information you might wish to draw to our attention to, that may help improve our understanding and fair decision-making (you may continue on a separate sheet).
I understand that any failure to disclose all convictions, cautions or warnings may result in the withdrawal of any offer of employment. If I am subsequently employed and previous convictions, cautions or warnings come to light, I understand this could result in dismissal in accordance with Mindset’s Procedures.
I also understand that once employed failure to disclose any future criminal investigations, convictions, cautions or warnings against me could result in dismissal in accordance with Mindset’s Procedures.

If you would prefer not to return this form via email, please complete and bring to your interview with you if you are selected.