(1) I confirm that the information given above is complete and correct, and that I understand that any incomplete, untrue or misleading information given to the employer will entitle the employer to reject my application, withdraw any employment offer made, or, if I am employed, dismiss me without notice. (2) I agree that the employer reserves the right to require me to undergo a medical examination to assess my suitability to work.

Before you can be considered for appointment in a position of trust with CONTENTO SOCIAL HOMES CIC we need to be satisfied about your character and suitability. Please read the following notes carefully before completing this declaration form. If you require further information, please contact: CONTENTO SOCIAL HOMES CIC 95a Charlotte Road, Stirchley, Birmingham, B30 2BT. All enquires will be treated in confidence. CONTENTO SOCIAL HOMES CIC aims to promote equality of opportunity and is committed to treating all applicants for positions fairly and on merit regardless of race, gender, marital status, religion, disability, sexual orientation, age or offending history. We undertake not to discriminate unfairly against anyone on the basis of criminal conviction or other information declared. Prior to making a final decision concerning your application, we shall discuss with you any information declared by you that we believe has a bearing on your suitability for the position. If we do not raise information with you, this is because we do not believe that it should be taken into account. In that event, you remain free to discuss any of that information or any other matter that you wish to raise. As part of assessing your application, we will only take into account relevant criminal record and other information declared. The Data Protection Act 1998 requires us to provide you with certain information and to obtain your consent before processing sensitive data about you. Processing includes: obtaining, recording, holding, disclosing, destruction and retaining information. Sensitive personal data includes any of the following information: criminal offences, criminal convictions, criminal proceedings, disposal or sentence. The information that you provide in this Declaration Form will be processed in accordance with Data Protection Act 1998, and will only be used for the purpose of determining your application for this position. Once a decision has been made concerning your appointment, we will not retain this Declaration Form longer than is necessary. This Declaration Form will be kept securely and in confidence, and access to it will be restricted to designated persons within CONTENTO SOCIAL HOMES CIC and other persons who need to see it as part of the selection process and who are authorized to do so. Please ensure that you read the “Guidance Notes for Applicants” that accompanied your application form carefully before completing this Declaration Form. They provide you with further and more detailed information concerning how your application will be processed, and include details for which information about you will be processed, the persons to whom it will be disclosed and the checks that will be undertaken to verify the information provided before you are offered a position if your application is successful. Please will you answer all of the following questions. If you answer ‘Yes’ to any of the questions, please provide full details in the space indicated. Please also use the space below to provide any other information that may have a bearing on your suitability for the position for which you are applying. You may continue on a separate sheet if necessary and you may attach supplementary comments should you wish to do so. The position for which you have applied is exempt from the Rehabilitation of Offenders Act 1974. This means that you must declare all criminal convictions, including those that would otherwise be considered “spent”. With the exception of question 8 answering ‘Yes’ to any of the questions below will not necessarily bar you from appointment. This will depend on the nature of the position for which you are applying and the particular circumstances.

I have read the “Guidance Notes for Applicants” that accompanied my application form, and I consent to the information provided in this Declaration Form being used by CONTENTO SOCIAL HOMES CIC for assessing my application. I confirm that the information that I have provided in the Declaration Form is correct and complete. I understand and accept that if I withhold information or provide false or misleading information this may result in my application being rejected, or if I am appointed in my dismissal.

The Company Contento Homes Ltd is opposed to discrimination on any grounds. We oppose discrimination on the grounds of race, religion, ethnic origin, sex, sexuality, marital status, disability or age. We are committed to ensuring that ability and potential for the job are criteria used for all staff selection.

The Company has adopted the provisions contained in the Code of Practice published by the Equal Opportunities Commission for Racial Equality and the Code of Practice published by the Equal Opportunities Commission that employers should regularly monitor the effects of selection decisions to assess whether equal opportunities is being achieved. For this purpose, you are asked to complete and return the form below with your application form. This information is for statistical reasons only and will be treated as confidential.