Learner Declaration FormLearner Declaration Form This form is to ensure learners have every opportunity to disclose any information that could impact on them enrolling on a course of education at Achievement Training LTD and would place staff and learners at risk of harm, also being able to work with children, young people and vulnerable adults as a paid member of staff or volunteer.Data ProtectionI consent to Achievement Training processing my personal data under Data Protection legislation for the purposes of Article 6 (1) (a) with my consent and 6 (1) (b) to process my information for the performance of the contract in relation to the academic year of the course I have applied for.A person may be disqualified from being able to work with children, young people and vulnerable adults if:Having committed certain offencesHaving certain orders or other restrictions placed upon themLiving in the same household as someone who is disqualified by virtue of 1 or 2 above (this is known as disqualification by association). Please note this condition also applies to someone who is working in the household where you are living. You are required to answer the questions below and sign the declaration at the end of this form confirming that you are not disqualified from working or have restrictions to be around children, young people or vulnerable adults.A disqualified person is not permitted to continue to work in a setting providing care unless they apply for and are granted a waiver from OFSTED. If applicable, please provide the name of your employer / work placement:Criminal Convictions: To help us look after all our learners and assess risks please let us know if you have any criminal convictions as referred to below? Achievement Training LTD is an inclusive environment and we are keen for all learners to be well cared for. We therefore ask all applicants to declare if they have any current (unspent) criminal convictions of a violent or sexual nature, or for the unlawful supply of controlled drugs or substances. Yes NoHave any orders or other restrictions related to being around children, young people or vulnerable adults been made in respect of you? Yes NoHave any orders or other restrictions related to care been made in respect of a child, young person or vulnerable adult in your care? Yes NoAre you barred from working with Children, young people or vulnerable adults by the Disclosure and Barring Service (DBS)? Yes NoIs there any other relevant information that could prevent you from working or being around with children young people and vulnerable adults or could have an effect on you being able to gain employment or volunteer in a workplace? (This includes people you live with.) Yes NoDeclaration: In signing this form, I confirm that the information provided is true to the best of my knowledge and that:I understand that I must notify Achievement Training immediately of anything that affects my suitability including any pending court appearances, cautions, warnings, convictions, orders or other determinations made in respect of me or a member of my household that may render me disqualified from working with children, young people, vulnerable adults or place Achievement Training LTD staff, learners and the public at risk of harm. Learner First NameLearner SurnameLearner Date of Birth:Learner Signature: Sign HereSubmit Form
