BANSTEAD DISTRICT SCOUTS
APPLICATION FOR MEMBERSHIP:
EXPLORER UNIT: Banstead District Explorers / Central District Explorers / Tadworth District Explorers (circle
required unit)
APPLICANT’S FULL NAME
ADDRESS
POST CODE
TELEPHONE NUMBER
DATE OF BIRTH
RELIGION (see page 4)
ETHNICITY (see page 4)
NHS Number
NATIONALITY
……………………………….
EMAIL (applicant)
SCHOOL
ANY PREVIOUS SCOUTING / GUIDING – LIST GROUPS
ANY SPECIAL MEDICAL OR DIETARY REQUIREMENTS
ANY OTHER RELEVANT INFORMATION
DOCTOR’S NAME
SURGERY ADDRESS
SURGERY POST CODE
SURGERY TELEPHONE NUMBER
Page 1 of 4
Mother / carer
Father / carer
Extra Emergency
Contact (not one of the
parents)
Full name
Former name
Address (including
post code)
Telephone number
Mobile number
Email address
Occupation
Date of birth
Any previous
scouting / guiding
experience
Which of the following can you help with…….please tick
I would be willing to assist the Unit by becoming a Leader
I would be willing to assist the Unit by becoming an Occasional Helper
I would be willing to assist the Unit by becoming a Skills Instructor (Possession of specific skills, to
be called on when required).
I would be willing to go on a parent rota to assist my child’s Unit
I would be willing to assist the Unit by helping at fundraising activities
I would be willing to assist the Unit by helping with building or grounds maintenance.
Page 2 of 4
I would be willing to assist the Unit by helping with vehicle or equipment maintenance
I would be willing to assist the Unit by driving members to and from activities held outside Unit
Headquarters
I have the following skills and qualifications with
which I would be willing to assist the unit when
required:
I would prefer to help the unit by:
I give permission for my son / daughter to be in photographs taken at Unit or Section activities that may be
used in Scouting publicity, provided names are not published.
I accept my responsibility in the running of the Unit and agree to support the leaders in what they do for
the benefit of the members.
I also accept my responsibility in the running of the unit by paying the annual membership subscriptions
and other fees, when requested.
I will support all Unit activities, both Scouting and fundraising and will assist where feasible in maintaining
group premises and equipment.
Data Protection:
The Scout Association is a registered Data Controller and is subject to the Data Protection Act
1998 and the principles within this. The Explorer Scouts of Banstead, as part of the Scout
Association, are subject to the same principles of Data Protection.
By signing this application, I agree to the Unit / Section, during and beyond my child’s membership,
retaining my personal data and that of my child to facilitate any present or potential future involvement with
Scouting including data regarding religion and / or special needs / disabilities.
Signed
Signed
(Mother / female carer)
Date
(Father / male carer)
Date
When fully completed, please return this form to Mrs Karen Arscott, 29 Parsonsfield Road, Banstead,
Surrey, SM7 1JW for the applicants name to be placed on the Group’s waiting list or for the applicant to
join the appropriate section or email to [email protected]
Page 3 of 4
Inclusivity Information
Ethnicity
Please enter one of the below onto the ethnicity section of the application form:
White




English/Welsh/Scottish/Northern Iris
Irish
Gypsy or Irish Traveller
Any other White background
Mixed/Multiple Ethnic Background
 White and Black Caribbean
 White and Black African
 White and Asian
 Any other mixed/multiple ethnic background
Asian/Asian British
 Indian
 Pakistani
 Bangladeshi
 Chinese
 Any other Asian background
Black/African/Caribbean/Black British
 African
 Caribbean
 Any other African/Caribbean/Black ethnic background
Other Ethnic Group
 Arab
 Other:_______________________________________
Prefer not to say
Religion of Faith
Please enter one of the below onto the Religion section of the application form:









Buddhist
Christian (all denominations)
Hindu
Jewish
Muslim
Sikh
Any other religion:__________________________________
No religion
Prefer not to say
Page 4 of 4