Criminal Offence Declaration (London Devilettes)

PrintCriminal Offence Declaration

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:_______


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Printed from londondevilettes.ca on Sunday, August 19, 2018 at 11:02 AM