Support Member Application Form – Search and Rescue Lincolnshire

Fields marked with * are required

Full Name *

Your Email *

Mobile Contact Number *

Home Address *

Date of Birth *

Able to help at Fundraising Events *

Yes
No
Maybe

Able to help Supporting Team or Public *

Yes
No
Maybe

Are you available on weekdays? *

Yes
No
Maybe

Are you available on evenings and weekends? *

Yes
No
Maybe

Do you have a full driving licence? *

Do you have a LGV driving licence? C1, C, C1E, CE. *

Do you have use of a motor vehicle? *

Your vehicle model

Vehicle Registration Number

Have you an Enhanced DBS? *

If Yes Certificate Number

Is your DBS on the Update Service? *

If Yes Update reference number

Next of Kin - Full Name

Relationship

Next of Kin - Contact Number

Next of Kin - Email Address

Declaration *

I understand that being a member of 'Search and Rescue - Lincolnshire' is an active service that may place physical and mental pressures on those who participate; also, that it is my responsibility to inform the Team Leader of any health condition or change of health condition that may affect my safety and wellbeing whilst on duty. 'Search and Rescue - Lincolnshire' retains information about its members in electronic and paper form. All information from this form will be kept on file. This information will not be disclosed to any agencies outside Search and Rescue – Lincolnshire. Ticking this box indicates your acceptance of the above.