Offence Declaration Form Complete Form Offence Declaration Form Appendix A: Offence Declaration Form Employee First Name Employee Last Name School Year - Select School Year -2022-232023-242024-25Offence Declaration I declare 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 the following convictions for offences under the Criminal Code of Canada for which a pardon under the Criminal Code of Canada Records Act of Canada has not been issued or granted to me.Number of Offences: - Select -123456Offence 1: Date / Time Offence 1: Court Location Offence 1: Conviction Offence 2: Date / Time Offence 2: Court Location Offence 2: Conviction Offence 3: Date / Time Offence 3: Court Location Offence 3: Conviction Offence 4: Date / Time Offence 4: Court Location Offence 4: Conviction Offence 5: Date / Time Offence 5: Court Location Offence 5: Conviction Offence 6: Date / Time Offence 6: Court Location Offence 6: Conviction Signature Sign Here Date / Time Submit Form