Police Declaration (West Lorne Comets)

Print Police Declaration

If WLMHA has a current Police Record Check on file, please complete the following. If you are not comfortable entering this information online, please contact the Registrar for a paper form.

Personal Information

Name^*
Address^*
Phone Number^*

OMHA Police Check^*
I have NO convictions for offenses under the Criminal Code of Canada as outlined in the OMHA Police Record Check Policy, 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 offenses under the Criminal Code of Canada as outlined in the OMHA Police Record Check Policy, which a pardon has not been issued or granted under the Criminal Records Act (Canada).
If you identified that you have offenses on your record, please list them below.

If you are not comfortable entering this information into the form, please submit the form and contact the Registrar.

Human Validation

Check The Box ^*

Police Declaration (West Lorne Comets)

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