Offence Declaration Form Page 2

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INSTRUCTIONS
1.
To be completed annually by all Board employees before assuming assignment in
September.
2.
Employees are to complete all areas and sign (in ink).
3.
Instructions for completing this form:
a) If you currently have convictions, please note them in the space provided.
b) Fill in the current date at the bottom of the form.
c) Sign in space provided.
d) Forward this completed form to the Human Resources Department in a sealed
envelope marked “CONFIDENTIAL”.

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