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Office Of Siridantamahapalaka

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Office Of Siridantamahapalaka: Template No.: T284 Template Title: Staff & Volunteer Code of Conduct Acknowledgement Form

Chronological Archive

Template No.: T284 Template Title: Staff & Volunteer Code of Conduct Acknowledgement Form

on

 THE HSWAGATA BUDDHA TOOTH RELIC PRESERVATION MUSEUM

FOR INTERNAL USE ONLY

Template No.: T284

Template Title: Staff & Volunteer Code of Conduct Acknowledgement Form

Related Research Case IDs / Cluster: _______

Linked Templates / Policies: _______________

Date of form: ____ / ____ / ______

Prepared by / Role: _______________________

Office / Unit: ____________________________

Country / Location: _______________________

Confidentiality Level:

Internal only [ ] Restricted [ ] Sacred-Restricted / Sensitive

Use of this form (tick):

New case / action [ ] Follow-up [ ] Annual review [ ] Archive only

T284 – Staff & Volunteer Code of Conduct Acknowledgement Form

Purpose:
This form confirms that a staff member or volunteer has read the HSWAGATA Code of Conduct and agrees to follow it.

A) Person details (to be completed by staff/volunteer)

  • Full name: _______________________________________________

  • ID / Staff No. (if any): ____________________________________

  • Role (tick): Staff [ ] Volunteer [ ] Intern [ ] Consultant [ ] Monk/Nun support role [ ] Other: ______

  • Department / Unit: ________________________________________

  • Supervisor / contact person: ________________________________

  • Phone / Email: ____________________________________________

B) Code of Conduct acknowledgement (tick all)

I confirm that I have received and read the HSWAGATA Code of Conduct (version: ________).
I understand and agree that I must:

  • Treat everyone with respect. No bullying, hate speech, or discrimination. [ ]

  • Protect confidentiality. I will not share internal or sensitive information without permission. [ ]

  • Protect sacred items and museum property. I will follow all safety and access rules. [ ]

  • Follow safeguarding rules. I will help keep children and vulnerable people safe. [ ]

  • Avoid conflicts of interest. I will declare gifts, money, or personal benefit that can influence my work. [ ]

  • Use honest speech and calm behaviour in disagreements. [ ]

  • Report concerns quickly (safety, misconduct, corruption, theft, damage, harassment). [ ]

  • Follow instructions on uniforms, ID badges, photos, social media, and visitor communication. [ ]

Where to report a concern (fill in by office):

  • Safeguarding / Ethics focal person: ______________________________

  • Phone / Email: _______________________________________________

  • Emergency contact (security / duty officer): ______________________

C) Optional notes (if any)

(Example: training needed, accessibility needs, language support.)

D) Signature

By signing below, I confirm the statements above are true.

  • Name (print): ____________________________________________

  • Signature: _______________________________________________

  • Date: ____ / ____ / ______

Witness / Supervisor (optional but recommended):

  • Name (print): ____________________________________________

  • Role: _________________________________________________

  • Signature: _______________________________________________

  • Date: ____ / ____ / ______

Office filing (for Office Use Only):

  • Form received by: ________________________ Date: //______

  • Stored in: Personnel file [ ] Volunteer file [ ] Training file [ ]

  • Next refresher / re-sign due date: ____ / ____ / ______