Offence Declaration Form - Board of Directors I DECLARE, since the last Criminal Records Check* provided to Big Brothers of Greater Vancouver (BBGV) or since the last Offence Declaration Form submitted to BBGV that:*Includes a Vulnerable Sector check for those who are in a position of trust.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).(Required) Yes No I have no pardons related to sexually based offences up to and including the date of this declaration under the Criminal Records Act (Canada).(Required) Yes No I have no charges pending under the Criminal Code of Canada up to and including the date of this declaration.(Required) Yes No 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.(Required) Yes No My driver’s license has not been suspended or restricted for any reason.(Required) Yes No 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). 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 BBGV.(Required) Yes Your Full Name(Required) Date(Required) MM slash DD slash YYYY Your Signature(Required)Full Name of Witness(Required)
