UNIVERSITY OF WARWICK
PGCE Primary, PGCE Early Years and EYITT Suitability Assessment
Guidance for completing this form
All applicants must complete sections 1 and 4.
In addition, applicants for non-salaried routes must complete section 2.
Applicants for salaried routes must complete section 3.
Section 1
Suitability Declaration for all PGCE Applicants
Warwick Student Number
Date of Birth
Your Name
Course applied for
The University of Warwick has a responsibility for ensuring that all applicants for Initial
Teacher Training courses are considered to be ‘fit to practise’ as set out in University
Regulation 341.
Please complete this form so the University can consider your suitability for the
aforementioned course. The information you put on this form will be considered in addition
to your DBS disclosure. The University will not use the information you declare on this
form when it considers your academic suitability for the course you have applied for.
However, before an offer of a place is made, the University will consider your fitness to
practise in accordance with Regulation 34. Any false declaration may lead to your offer
being withdrawn.
If you answer ‘Yes’ to any question, in the space below you should give the full details of the
sanction, date, reason and identify the police force, authority, court or other body concerned.
If you need additional space, please attach additional sheets as required.
All applicants please respond to all questions in this section by deleting as appropriate.
1. Have you ever been the subject of a bar, partial bar, warning or
other sanction by the Secretary of State in relation to working with
children, or misconduct?
2. Do you have any convictions, cautions, reprimands or final
warnings which would not be filtered in line with current guidance?
The DBS filtering guidance is available on the DBS website at
www.gov.uk/government/publications/dbs-filtering-guidance.
Yes
No
Yes
No
3. Have you ever been subject to any disciplinary sanction by any
professional or regulatory body in this country or abroad, or are you
currently the subject of investigation by such a body?
Yes
No
4. Is there a current employment disciplinary finding against you/or are
you currently the subject of an employer’s disciplinary investigation?
Yes
No
Yes
No
5. Is there any other information the University should know about
which may have a bearing upon your suitability to enrol for an Initial
Teacher Training course. (As a registered teacher you will be
responsible for upholding and promoting the standards of the
profession. Relevant information would include any involvement in
activities which could bring the reputation of the profession into
disrepute.)
Please provide any pertinent information:
Childcare Disqualification Requirement 2015-16
Guidance on DfE Disqualification under the Childcare Act 2006 can be found here:
https://www.gov.uk/government/publications/disqualification-under-the-childcare-act-2006
Statutory guidance, Keeping Children Safe in Education requires ITE providers to ensure
that entrants on all routes, including salaried schemes, have been subject to Disclosure
and Barring Service (DBS) criminal records check including a check of the children’s
barred list.
Definitions:
Disqualified from Caring for Children (Children’s Act 1989 Section 68(3))
You may be disqualified if you have been:
 convicted of an offence against a child (for example murder, kidnapping, rape,
indecent assault, assault causing actual bodily harm);
 included on the barred list of persons considered unsuitable to work with children,
which is held by the Independent Safeguarding Authority;
 made the subject of an order where a child has been removed from your care or
prevented from living with you;
 refused registration as a childcare or children’s home provider previously, or had
your registration cancelled.
You are also disqualified if you live in the same household as another person who
is disqualified or if you live in a household where a disqualified person is
employed.
Please answer the appropriate questions and sign the declaration overleaf to demonstrate
that you are safe to work with children. If there are any aspects of the declaration you are
not able to meet, you should disclose this immediately to the University/your Programme
Leader /employer.
Section 2
EYITT, PGCE Primary or PGCE Early Years students not employed by schools or
nurseries, please respond to all questions in this section by deleting as appropriate.
6. Are you ‘Disqualified for Caring for Children’: (see definition above)
a) Have you committed any offences against a child?
Yes
No
b) Have you committed any offences against an adult (e.g. rape,
murder, indecent assault, actual bodily harm etc.)?
Yes
No
c) Have you been barred from working with children (DBS)?
Yes
No
d) Are you living with someone who has been barred from working
with children (DBS)?
Yes
No
e) Are you living in the same household as someone who has
been disqualified from working with children under the
Childcare Act 2006?
Yes
No
f) Have your own children been taken in to care?
Yes
No
g) Have/are your own children the subject of a child protection
order?
Yes
No
Please provide any pertinent information:
Section 3
EYITT, or PGCE salaried students employed in childcare settings/schools please
respond to all questions in this section by deleting as appropriate.
7. Please confirm that you understand that your employer will carry
out the DBS check.
Yes
No
8. Please confirm that you understand that your employer will carry
out the Childcare Disqualification Check.
Yes
No
Please provide any pertinent information.
Section 4
Declaration
I declare that:
All of the information I have provided on this form is complete and correct to the best of
my knowledge.
I understand that the University may withdraw any offer of a place made to me if I have
given false information or have withheld relevant details.
I understand that the University may contact me about information in my application and
on this form and may seek further information from any police force, authority, court or
other body I have named.
I agree to tell the University as soon as reasonably practical about any changes to the
information I have supplied above.
I understand that the University will investigate any declaration I have made above in
accordance with its Ordinances and Regulations (set out at
www.warwick.ac.uk/go/calendar), and with reference to relevant statutory guidance.
By signing this form I confirm that I understand my responsibility to safeguard children and
am aware that I must notify the University/ my Programme Leader/employer of anything I
feel may affect my suitability.
I give permission for you to contact any previous settings, local authority staff, the police,
the DBS, or any medical professionals to share information about my suitability to care for
children. *
Signed:
Print name:
Date:
*The information collected in this form is held with the strictest confidence.
Please return this form in an envelope marked ‘confidential’ to:
Postgraduate Admissions Service
Student Recruitment, Outreach & Admissions Service
University House
University of Warwick
Coventry
CV4 8UW
United Kingdom