LEAP Registration Form

Your Name

Please enter your full name.

First Name

Last Name

Address

Address 1

City

ZIP / Postal Code

Telephone Number

Email Address

Please enter your email so we can get in touch.

Date of Birth 00/00/0000

Can you travel to the meetings?

Yes

Tell us about any support you may need to travel.

Have you ever been convicted of a criminal offence?

Yes

Criminal Offence Details

Tell us about your skills and experience.

Please enter your comments.

Tell us why you want to do this work.

Please enter your comments.

Declaration

Declaration

Giving false or incorrect information can result in being disqualified from the registration process or fired from my role.
The information on this form may be stored and processed by People First for a period of six months.
If successful the information will be held on my personal file during and following my employment.
Under the Rehabilitation of Offenders Act,
Failure to give any convictions spent or otherwise will result in non-appointment or disciplinary action and possible firing.
I agree to a disclosure being made by the Criminal Records Bureau about the existence and content of a criminal record spent or otherwise.
All information in this application form will be treated as confidential and used only for employment purposes.

Giving us information is giving your permission to it being processed for all employment purposes as said in the Data protection Act 1998 and any confirmation checks that may be made.
To the best of my knowledge I declare that the information given in this registration form is correct and true. To the best of my knowledge I declare that the information given in this registration form is correct and true. I understand that:

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