Confidentiality Declaration 

This pro-forma is based on the form in Practice guidance: Safer Recruitment, House of Bishops 2015.  It should be completed by those wishing to work with children or vulnerable adults.  The Confidential Declaration Form applies to clergy, employees, ordinands, other adults and volunteers who are likely to be in regular contact with children or vulnerable adults.  This form is strictly confidential and, except under compulsion of law, will be seen only by those responsible for the appointment and, when appropriate, the Diocesan Safeguarding Adviser or someone in a similar position. All forms will be kept securely under the terms of the Data Protection Act 1998.
If you answer yes to any question, please provide details, giving the number of the question you are answering.