Safer Recruitment Questions

First Name:

Last Name:

E-mail:

Have you ever had registration refused or cancelled in relation to childcare or children’s homes or being disqualified from private fostering in the United Kingdom or in any other country? Yes No
Are you living in the same household where another person who is disqualified lives or works (disqualification ‘by association’)? If YES, please provide the following information about you or any person who lives in the same household as you:
  •  details of any order, determination, conviction, or other ground for disqualification from registration under the Childcare (Disqualification) Regulations 2009;
  • the date of the order, determination or conviction, or the date when the other ground for disqualification arose;
  • information about the body or court which made the order, determination or conviction, and the sentence (if any) imposed; and
  • a certified copy of the relevant order (in relation to an order or conviction).
Yes No
Have you ever been disqualified from a practice on grounds relating to the care of children (including where an order is made in respect of a child under the person’s care) in the UK or in any other country? Yes No
If you have answered yes to any of the questions, please explain your answers in more detail here: