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I DECLARE, since the last Criminal Records Check* provided to Big Brothers Big Sisters of Guelph, or since the last Annual Offence Declaration Form submitted to Big Brothers Big Sisters of Guelph, that (please check all boxes that apply):

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).
I have no pardons related to sexually based offences up to and including the date of this declaration under the Criminal Records Act (Canada).
I have no charges pending under the Criminal Code of Canada up to and including the date of this declaration.
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.
My driver’s license has not been suspended, restricted or revoked for any reason.
Please check the appropriate line: (A) There have been no occurrences as described above since my last Criminal Record Check or submission of an Annual Offence Declaration Form. OR (B) All reportable matters as described above were discussed with Agency Staff and/or the Executive Director at the time of the occurrence(s).(Required)
Offence Declaration(Required)
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Name(Required)
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