1. Appendix C


       

       



      Appendix C

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      This information is collected under the authority of the Education Act and in compliance with the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and will be used for the purposes of obtaining a declaration from prospective Niagara Catholic volunteers that they have not been convicted of an offence under the Criminal Code of Canada. Questions about this collection should be directed to the relevant Superintendent of Education, Niagara Catholic District School Board, 427 Rice Rd., Welland, ON L3C 7C1 (905.735.0240).

       

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      Volunteer Offence Declaration

       

      Name of Volunteer:   

               		 
       
      First Name (please print)
      Last Name (please print)
       


      I am the parent/guardian of:
       

               		  
      First Name (please print)
      Last Name (please print)
      Grade
       

               		  
      First Name (please print)
      Last Name (please print)
      Grade
       

               		  
      First Name (please print)
      Last Name (please print)
      Grade
       


       

       





      DECLARATION
      I DECLARE, since the last Police Vulnerable Sector Check or Volunteer Offence Declaration collected by the Niagara Catholic District School Board, that:

       

       

      ☐ I have NO criminal convictions for offences 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).  
       
      Date (mm-dd-yyyy)
      		 
      Signature of Volunteer
       

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      Please return this form to the school principal in a sealed envelope marked:

      Volunteer Offence Declaration-Confidential

       

      Submission of false information on an Offence Declaration will result in termination of a volunteer service.

       


       

          February 2026