NORTH MANCHESTER SCOUT DISTRICT

DBS Form

This form is required for all adults joining Scouting and for those adults whose

DBS requires renewing.

A lot of the information asked for is required to enable the essential checks to be undertaken – all information provided is treated with confidentiality and is destroyed once DBS input completed.

To assist in completion of the form explanation notes are added (in italics)

If you require any assistance or have any questions, then there are people you can ask

  1. Your section Leader
  2. Your Group Scout Leader
  3. The District Commissioner (Katherine Kennedy)
  4. The Appointments Secretary

Sue Birtles

Appointments Secretary - North Manchester

Your Details

Title
Forename
Middle Name(s)
Surname
Name at Birth
Town of Birth
Date of Birth

If your name now is different to name at birth, please provide the date (month and year) when your name changed)

Month / Year

Address Details

House name/ number
Street Name
Town
Post Code

Date in which you moved into this property

Month / Year

If you have lived here for less than 5 years, it is essential that all addresses for last five years are provided – please use separate sheet

Personal Contact Details

Telephone number
Email

(These will be used to contact you if additional information required and will be recorded on the Compass site)

This next section lists all required to enable the DBS check to be undertaken – the more information provided the easier it is for everyone.

If you have a Passport, Driving Licence and original Birth Certificate then no additional information will be required.

If you only have one or two, then you will need to produce copies of something with your current address on (a full list is attached at end of form)

Driving Licence – must be a full licence

Photocard or old paper one
Country of Issue
Date of Issue
Licence number

(It is essential that you include the last two numbers at the very end)

Date of Birth on Licence

Passport – this must be a current passport

Passport Number
Date of Issue
Nationality
Expiry Date
Date of Birth on passport

Birth Certificate – this must be an original (dated within twelve months of birth)

Date of Certificate
Country of Issue
Town/Country

If all three pieces of information have been provided, then no further evidence required. If only one or two, then additional information will be required as a photocopy and it can be any two from the list below

Documents issued within last 12 months

  • Council Tax statement
  • Financial statement e.g. pension, endowment, ISA (UK)
  • Mortgage statement (UK or EEA)
  • P45 certificate statement / P60 certificate statement - NI number on P45/P60

Documents issued within last three months

  • Bank or building society account opening confirmation letter
  • Issue date Bank or building society statement
  • Electricity/Gas bill/statement (UK)
  • Credit card statement
  • Telephone bill/statement (not mobile telephone)
  • Water bill/ Benefit statement e.g. child benefit, pension
National Insurance Number

(This is essential – without it we cannot undertake any DBS check or add you to Compass)

Do you have any criminal convictionsYes☐No☐

Finally……….

Name of Scout Group
Name of Section
Role you are undertaking

This form must be signed by your Group Scout Leader (who must see all documents used)

Signature of GSL
Name of GSL
Membership number of GSL

ADDITIONAL INFORMATION REQUIRED IF YOU ARE NEW TO SCOUTING OR CHANGING YOUR ROLE OR GROUP

Two referees are required – and they cannot be friends only or someone you have only known for less than 2 years.

Referee 1

Name
Address
Telephone Number
Email

Referee 2

Name
Address
Telephone Number
Email

Your appointment will be delayed if referee details not provided.

ADDITIONAL ADDRESS INFORMATION IF REQUIRED

It is essential that we have all addresses for the last five years – if your current address meets this then no additional addresses needed.

Previous addresses

House name/ number
Street Name
Town
Post Code

Date moved in

Month / Year

Date moved out

Month / Year

Please repeat above until a full five years covered.