Offence Declaration Form Offence Declaration I DECLARE, since the last Criminal Records Check provided to Big Brothers Big Sisters of Greater Moncton, or since the last Offence Declaration Form submitted to Big Brothers Big Sisters of Greater Moncton, that:(Required) I have no convictions under the Criminal Code of Canada up to and including the date of this declaration for which a pardon has not been issued or granted under the Criminal Records Act (Canada). I have no pardons related to sexually based offences up to and including the date of this declaration under the Criminal Records Act (Canada). I have not been the subject of any criminal investigation or allegation, any child welfare investigation or allegation, nor have I had any charges brought against me, even if the charges are pending. My driver’s license has not been suspended or restricted for any reason. Please check the appropriate line:(Required)There have been no occurrences as described above since my last Criminal Record Check or Offence Declaration Form.All reportable matters as described above were discussed with Agency Staff and/or the Executive Director at the time of the occurrence(s).Consent I hereby attest that the information disclosed herein is true, complete and accurate to the best of my knowledge and belief. I understand that failure to complete an accurate and truthful Offence Declaration will lead to a review of my continued service with Big Brothers Big Sisters of Greater Moncton.Name(Required) First Last Date(Required) MM slash DD slash YYYY Email(Required) Facebook Twitter Google+ LinkedIn
