OWHA Criminal Offence
Declaration
CRIMINAL OFFENCE
DECLARATION
Print Name: _________________________________
Position: ____________________________________
Team/Association _____________________________
I,_____________________, hereby declare that:
I have no convictions or outstanding charges
for offences under the
Criminal Code of Canada as specified in the
OWHA Policy for Police
Record Checks 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).
OR
I have the following convictions for offences
under the Criminal Code
of Canada as specified in the OWHA Policy for
Police Record
Checks for which a pardon under the Criminal
Records Act (Canada)
has not been issued or granted:
_____________________________________
_____________________________________
_____________________________________
Signature of Applicant:
____________________Date:_______