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Criminal records and health declaration form

You must read the recruitment of ex-offenders section within the Admissions Policy for De Montfort University (DMU) before completing this declaration form. The policy is available on the DMU website under Admissions Policy, Applying – Section 8.

The Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 has been amended. The consequence of the amendment is that certain spent convictions and cautions are ‘protected’ and are not disclosed to employers and others entitled to conduct Disclosure and Barring Service (DBS) checks. Spent convictions and cautions that are protected, therefore, should not be disclosed to, or taken into account by, the University when considering your application.

‘Protected’ cautions will include some cautions which are historic. Specified periods will need to have elapsed, depending on whether a person was under 18, or 18 or over at the time the caution was given. A conviction may be protected if it is historic and, as for cautions, a prescribed period of time will need to have elapsed since the conviction and that period depends on whether a person was under 18, or 18 or over at the time of the conviction. Protection will not apply if a person had any other conviction and/or if a custodial sentence was issued. Cautions and convictions for “listed” offences (as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975) will never be protected and will therefore be disclosed in a DBS check.

The information provided above in this application form is only intended to be a brief summary and should not be relied upon alone.

Before you complete this form therefore, it is very important that you read guidance on and criteria for the definition of ‘protected’ convictions and cautions and the filtering of these convictions and cautions, which can be found on the DBS website. 

Applicants should disclose all spent and unspent criminal convictions, cautions, reprimands and warnings which would be displayed on an enhanced criminal record certificate which are not protected and would not therefore be filtered.

Failure to disclose any relevant information will put any offers of a place at risk under the anti-fraud UCAS procedures and will be viewed as a breach of trust by the University and Faculty. (De Montfort University, General Regulations and Procedures, Ch 1, section 3.7).

The information you provide may affect your ability to:

  1. Gain entry to your chosen course of study
  2. Attend the placement as part of your chosen course of study
  3. Evidence fitness to practise in your chosen career

Prior to making a final decision concerning your application, we shall first review your academic performance and if required, discuss with you any information you share with us on this declaration form that we believe has a bearing on your suitability for a place on your chosen course of study. We may also need to discuss the information you disclose with any relevant professional/statutory body and placement providers where we consider it necessary to do so, for example, in the interests of assessing your fitness to practise or eligibility for entry to the course and/or minimising risk to safety.

If you have previous spent or unspent convictions / cautions/ bind over/ street cautions/ reprimands/ fixed penalty notices and warnings which are not protected and will therefore not be filtered from your criminal record certificate, then you should declare it in this self-declaration form.The information that you provide in this declaration form will be processed in accordance with the Data Protection Act 1998. It will be used for the purpose of determining your application for this position.

If you require further information regarding the criminal records process adopted by the Faculty and De Montfort University, please contact the Admissions Team via email admissions@dmu.ac.uk

Subject to the limited provision for disclosure to third parties (e.g. placement providers/professional bodies) referred to in this form, this information will be treated in confidence and stored in accordance with the Data Protection Act, 1998.

  • Applicant name
  • Have you ever been convicted of a criminal offence in the United Kingdom or any other country? Are you currently bound over, or do you have any convictions or cautions (including warnings and reprimands) which are not deemed 'protected' as defined by the Rehabilitation of Offenders Act 1974 (Exceptions Order 1975 (as amended in 2013) and will not therefore be filtered from your criminal record certificate, issued by a Court or Court-Martial in the United Kingdom or in any other country?
  • Have you ever been CAUTIONED, STREET CAUTIONED, REPRIMANDED or received a WARNING by the police for any offence in the United Kingdom or any other country which is not defined as 'protected' as defined by the Rehabilitation of Offenders Act 1974 (Exceptions Order 1975 (as amended in 2013) and will not be filtered from your criminal record certificate?
  • Have you been charged with any offence in the United Kingdom or in any other country that has not yet come to court which Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)?
  • If YES (for any of the above) please specify the corresponding question your answer relates to (Please note that you will only need to declare spent and unspent convictions which are not “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) and will not be filtered from your criminal record certificate);
  • Are you currently under investigation for any alleged offence in the United Kingdom or in any other country?
  • The university has a duty to assess the fitness to practise of applicants to specific courses, for example Pharmacy and Nursing. For this reason, we need to obtain information relevant to an individual’s fitness to practise as a professional working with vulnerable members of the community. It is for this reason that we need to ask the following questions about previous conduct that might lead to or has led to sanction by a professional body, education institution and/or employer.
  • Are you currently or have you ever been the subject of any investigation, work related disciplinary or fitness to practise proceedings by a professional/statutory body, previous educational establishment or current or past employer in the United Kingdom or any other country?
  • You are required to notify De Montfort University regarding all past and present convictions, cautions, restorative justice, bind over, street cautions and warnings and fixed penalty notices. This requirement does not apply to cautions and convictions which are “protected “as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) and which will not therefore be filtered from your criminal record certificate. If you are accepted onto your chosen course of study, which is exempt from the Rehabilitation of Offenders Act 1974, you are required to notify De Montfort University of any changes relating to your criminal record (e.g. if you receive any new convictions, cautions etc). (De Montfort University, General Regulations and Procedures Ch 1, section 2.5) I declare that I have read the recruitment of ex-offenders section within the Admissions Policy for De Montfort University (available via the DMU website) and understand and agree to abide by the same. I can confirm that the information I have provided is a full and factual declaration and understand and accept that if I knowingly withhold information, or provide false or misleading information, this may result in my application being rejected or, if I have been accepted onto a course of study, my place being terminated. I consent to the information provided in this declaration form being used by the University for the purpose of assessing my application. I understand and consent that in exceptional circumstances, the University may be asked to disclose information on this form to a third party (e.g. placement providers, professional bodies), for the purposes of fitness to practise matters and placement provision.